Organization
UP-LEVEL NUTRITION COACHING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIOLETA MARTINEZ RD (OWNER)
(979) 702-8752
Entity
Organization
Contact information
Practice address
226 E VINE ST, LA GRANGE, TX 78945-1658
(979) 702-8752
Mailing address
226 E VINE ST, LA GRANGE, TX 78945-1658
(979) 702-8752
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952945917
INDIVIDUAL
TX
Enumeration date
08/31/2022
Last updated
08/31/2022
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