Organization
NUTRITION & FITNESS ON THE MOVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTELLE M BETHEA RDN (OWNER)
(703) 980-9842
Entity
Organization
Contact information
Practice address
3622 SERENDIPITY RD, WOODBRIDGE, VA 22193-1093
(703) 980-9842
Mailing address
3622 SERENDIPITY RD, WOODBRIDGE, VA 22193-1093
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DX3601
MD
Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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