Organization
INTENTIONAL WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA LYNN RIELLY MS, RDN (OWNER)
(732) 691-0341
Entity
Organization
Contact information
Practice address
1190 OLD FREEHOLD RD, TOMS RIVER, NJ 08753-5258
(732) 691-0341
Mailing address
1190 OLD FREEHOLD RD, TOMS RIVER, NJ 08753-5258
(732) 691-0341
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
04/20/2020
Last updated
03/20/2022
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