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Organization
VIVA VELOCITY, LLC
Active
Organization
VIVA VELOCITY, LLC
Active
Other names
Pearl Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN J KRESHA RD (OWNER)
(312) 952-6012
Entity
Organization
Contact information
Practice address
12330 PINECREST RD STE 125, RESTON, VA 20191-1655
(312) 952-6012
(844) 246-8462
Mailing address
12704 FANTASIA DR, HERNDON, VA 20170-2941
(312) 952-6012
(844) 246-8462
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467705079
NPI
VA
Enumeration date
10/31/2019
Last updated
07/25/2023
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