Healthcare Provider Details

I. General information

NPI: 1326447913
Provider Name (Legal Business Name): NUTRITION HEALTHWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 JOE KNOX AVE
MOORESVILLE NC
28117-9169
US

IV. Provider business mailing address

7985 NC HIGHWAY 150 E UNIT 24
TERRELL NC
28682-8753
US

V. Phone/Fax

Practice location:
  • Phone: 704-380-4655
  • Fax: 704-680-6672
Mailing address:
  • Phone: 704-380-4655
  • Fax: 704-680-6672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS BARTON CHILCOT
Title or Position: OWNER
Credential:
Phone: 704-380-4655