Provider Demographics
NPI:1881159564
Name:MCENROY NUTRITION
Entity type:Organization
Organization Name:MCENROY NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MCENROY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:774-254-0418
Mailing Address - Street 1:5 WEST ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2735
Mailing Address - Country:US
Mailing Address - Phone:774-254-0418
Mailing Address - Fax:
Practice Address - Street 1:34 SCHOOL ST STE 207
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2318
Practice Address - Country:US
Practice Address - Phone:774-254-0418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty