Organization
PHILADELPHIA NUTRITION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN O'MELIA M.S. (OWNER)
(215) 431-0968
Entity
Organization
Contact information
Practice address
2026 CHESTNUT ST, PHILADELPHIA, PA 19103-4446
(215) 431-0968
Mailing address
2026 CHESTNUT ST, PHILADELPHIA, PA 19103-4446
(215) 431-0968
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DN003994
PA
133V00000X
Registered Dietitian
DN003994
PA
Other
Enumeration date
11/03/2010
Last updated
09/19/2012
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