Organization
OPTIMAL NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RABITA SHETTLE RDN (OWNER)
(860) 916-2486
Entity
Organization
Contact information
Practice address
65 KELSEY LN, GLASTONBURY, CT 06033-5040
(860) 916-2486
Mailing address
65 KELSEY LN, GLASTONBURY, CT 06033-5040
(860) 916-2486
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/28/2023
Last updated
12/29/2023
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