Organization
KA WELLNESS AND NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUN D SKYRM (ADMINISTRATOR)
(330) 256-0533
Entity
Organization
Contact information
Practice address
2370 SOUTHEAST BLVD, SALEM, OH 44460-3418
(330) 333-8990
(330) 595-4727
Mailing address
13250 OLD HICKORY CT, NORTH LIMA, OH 44452-8527
(330) 256-0533
(330) 595-4727
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609403492
IND NPI
—
Enumeration date
02/07/2023
Last updated
02/07/2023
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