Organization
PATH OF LIFE NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY THOMAS PONDS MS, RDN, LD, IFNCP (OWNER)
(803) 575-0468
Entity
Organization
Contact information
Practice address
147 VERA RD STE A, LEXINGTON, SC 29072-3756
(803) 575-0468
(803) 728-3224
Mailing address
736 SHADOWBROOK DR, COLUMBIA, SC 29210-3751
(843) 599-9046
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8943
—
SC
Enumeration date
06/02/2015
Last updated
10/25/2023
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