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Organization
OPEN TABLE NUTRITION LLC
Active
Organization
OPEN TABLE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN ALVAREZ MS, RDN, CSOWM, LD (AUTHORIZED OFFICIAL)
(314) 282-5181
Entity
Organization
Contact information
Practice address
2941 CHAMPIONSHIP BLVD, SUITE LLC, SAINT LOUIS, MO 63129
(314) 282-5181
Mailing address
117 S LEXINGTON ST STE 100, HARRISONVILLE, MO 64701-2443
(314) 282-5181
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
Other
Enumeration date
06/30/2026
Last updated
08/18/2026
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