# WHOLESOME NUTRITION, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265778187
- **Authorized official:** CASEY MCKINNEY RD, LDN, CDE (REGISTERED DIETITIAN)
- **Authorized official phone:** (717) 576-6305

## Contact information

- **Practice address:** 400 HORSHAM RD, HORSHAM, PA 19044-2140
- **Practice address phone:** (215) 675-4535
- **Mailing address:** 305 GREENHILL RD, WILLOW GROVE, PA 19090-2812
- **Mailing address phone:** (717) 576-6305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | DN003959 | PA | Yes |

## Other

- **Enumeration date:** 12/20/2012
- **Last updated:** 12/20/2012