Healthcare Provider Details

I. General information

NPI: 1881658979
Provider Name (Legal Business Name): CENTER FOR NUTRITION AND PREVENTIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 SW URISH RD
TOPEKA KS
66614-5614
US

IV. Provider business mailing address

2840 SW URISH RD
TOPEKA KS
66614-5614
US

V. Phone/Fax

Practice location:
  • Phone: 785-273-4443
  • Fax: 785-228-9892
Mailing address:
  • Phone: 785-273-4443
  • Fax: 785-228-9892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY BETH HOLLAND
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 785-273-4443