Healthcare Provider Details

I. General information

NPI: 1992464184
Provider Name (Legal Business Name): THOMAS J HELLYER DIETITIAN & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10120 S EASTERN AVE STE 115
HENDERSON NV
89052-3952
US

IV. Provider business mailing address

PO BOX 778427
HENDERSON NV
89077-8427
US

V. Phone/Fax

Practice location:
  • Phone: 725-529-7989
  • Fax: 702-920-9966
Mailing address:
  • Phone: 725-529-7989
  • Fax: 702-920-9966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: THOMAS J HELLYER JR.
Title or Position: OWNER
Credential: RD, LD
Phone: 304-415-1384