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Organization

FUNDAMENTAL NUTRITION & WELLNESS, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATHAN L LORE MS, RD, LD, LMNT (OWNER)
(402) 202-6392
Entity
Organization

Contact information

Practice address
2690 W SUMNER ST, LINCOLN, NE 68522-4439
(402) 202-6392
Mailing address
2690 W SUMNER ST, LINCOLN, NE 68522-4439
(402) 202-6392

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1110
NE

Other

Enumeration date
08/14/2015
Last updated
08/14/2015
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