Organization
MAXWELL NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN MAXWELL (OWNER)
(757) 589-4293
Entity
Organization
Contact information
Practice address
3101 AMERICAN LEGION RD STE 23, CHESAPEAKE, VA 23321-5655
(757) 589-4293
Mailing address
1408 LONGSTREET LN, SUFFOLK, VA 23437-9621
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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