Organization
ON THE MOVE NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MARIE JURCAK MS, MPH, RD, LD (OWNER)
(440) 865-1266
Entity
Organization
Contact information
Practice address
9712 BALTIC RD, CLEVELAND, OH 44102-1719
(440) 865-1266
Mailing address
14837 DETROIT AVE STE 189, LAKEWOOD, OH 44107-3909
(440) 865-1266
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467929125
INDIVIDUAL NPI
—
01
—
LD.08277
LICENSURE
OH
Enumeration date
08/12/2020
Last updated
08/12/2020
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