# CHATTAHOOCHEE INSTITUTE FOR WELLNESS, LONGEVITY & WEIGHT MANAGEMENT

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

## Provider details

- **NPI number:** 1770366049
- **Authorized official:** BANTWAL SURESH BALIGA (MD)
- **Authorized official phone:** (706) 718-9556

## Contact information

- **Practice address:** 110 ENTERPRISE CT STE B, COLUMBUS, GA 31904-9231
- **Practice address phone:** (706) 507-0001
- **Practice address fax:** (706) 507-0016
- **Mailing address:** 110 ENTERPRISE CT STE B, COLUMBUS, GA 31904-9231
- **Mailing address phone:** (706) 887-7790
- **Mailing address fax:** (706) 507-0016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | NULL | Yes |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2023
- **Last updated:** 09/28/2023