Organization
ILIVEWELL NUTRITION THERAPY LLC
Active
Other names
iLiveWell Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIEN B PACZOSA RD, LD, CEDRD-S (OWNER)
(512) 547-9274
Entity
Organization
Contact information
Practice address
3724 JEFFERSON ST, SUITE 316, AUSTIN, TX 78731-6225
(512) 547-9274
Mailing address
3724 JEFFERSON ST, SUITE 316, AUSTIN, TX 78731-6225
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT80445
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700077062
—
TX
Enumeration date
05/06/2013
Last updated
05/01/2020
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