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Organization
NUTRIWELL LLC
Active
Organization
NUTRIWELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA M N RD (OWNER)
(267) 760-7770
Entity
Organization
Contact information
Practice address
4055 RIDGE AVE, 3608, PHILADELPHIA, PA 19129-1576
(267) 760-7778
Mailing address
4055 RIDGE AVE, 3608, PHILADELPHIA, PA 19129-1576
(267) 760-7778
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004001
PA
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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