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Organization
ON THE MOVE NUTRITION
Active
Organization
ON THE MOVE NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MARIE JURCAK MS, MPH, RD, LD (OWNER)
(440) 865-1266
Entity
Organization
Contact information
Practice address
9712 BALTIC RD, CLEVELAND, OH 44102-1719
(440) 865-1266
Mailing address
14837 DETROIT AVE STE 189, LAKEWOOD, OH 44107-3909
(440) 865-1266
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467929125
INDIVIDUAL NPI
—
01
—
LD.08277
LICENSURE
OH
Enumeration date
08/12/2020
Last updated
08/12/2020
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