OPTIMAL NUTRITION LLC NPI 1073086203

NPI Information

NPI: 1073086203
Provider Name: OPTIMAL NUTRITION LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
65 KELSEY LN
GLASTONBURY, CT
ZIP 06033
Phone: (860) 916-2486
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OPTIMAL NUTRITION LLC is a health service clinic center in Glastonbury, CT. OPTIMAL NUTRITION LLC NPI is 1073086203. The provider is registered as an organization entity type.

The provider's business location address is:

65 KELSEY LN
GLASTONBURY, CT
ZIP 06033-040
Phone: (860) 916-2486

The provider's authorized official is Lisa Rabita Shettle .
The authorized official title is Owner and has the following contact phone number (860) 916-2486.

The enumeration date for this NPI number is 1/10/2019 and was last updated on 1/10/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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