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Organization
ASHLEY REAVER NUTRITION LLC
Active
Organization
ASHLEY REAVER NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY REAVER RD (OWNER)
(240) 674-0948
Entity
Organization
Contact information
Practice address
331 LINDBERGH AVE, FREDERICK, MD 21701-4849
(240) 674-0948
Mailing address
331 LINDBERGH AVE, FREDERICK, MD 21701-4849
(240) 674-0948
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DX4421
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871070805
INDIVIDUAL NPI
MD
Enumeration date
08/13/2018
Last updated
08/13/2018
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