Organization
AMANDA LYNN NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LYNN STATHOS MS, RD, LD (OWNER)
(815) 321-1555
Entity
Organization
Contact information
Practice address
9031 ENDICOTT PL, LORTON, VA 22079-4541
(815) 321-1555
Mailing address
9031 ENDICOTT PL, LORTON, VA 22079-4541
(815) 321-1555
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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