Healthcare Provider Details

I. General information

NPI: 1841684826
Provider Name (Legal Business Name): HEALTHY WEIGHS NUTRITION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PRINCETON ST
GRAND FORKS ND
58202-6099
US

IV. Provider business mailing address

18711 445TH AVE SW
EAST GRAND FORKS MN
56721-9229
US

V. Phone/Fax

Practice location:
  • Phone: 218-779-9736
  • Fax:
Mailing address:
  • Phone: 218-779-9736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number943554
License Number StateND

VIII. Authorized Official

Name: MR. GABE ARNTSON
Title or Position: OWNER
Credential: MBA
Phone: 218-779-1287