Healthcare Provider Details

I. General information

NPI: 1831635127
Provider Name (Legal Business Name): NUTRITION ON THE GO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SEVEN LOCKS RD STE 360
ROCKVILLE MD
20854-6901
US

IV. Provider business mailing address

22841 GLACIER LILY DR
CLARKSBURG MD
20871-6331
US

V. Phone/Fax

Practice location:
  • Phone: 301-263-7319
  • Fax: 301-263-7319
Mailing address:
  • Phone: 240-447-4677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1083262
License Number StateMD

VIII. Authorized Official

Name: ANN PORTER
Title or Position: REGISTERED CLINICAL DIETITIAN
Credential: RDN, LDN
Phone: 301-263-7319