Healthcare Provider Details

I. General information

NPI: 1144734369
Provider Name (Legal Business Name): BEYOND EATING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 BRAEWICK CIR BY APPOINTMENT ONLY
AKRON OH
44313
US

IV. Provider business mailing address

1700 W MARKET ST # 148
AKRON OH
44313-7002
US

V. Phone/Fax

Practice location:
  • Phone: 330-873-1918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: AYESHA NURRUDDIN
Title or Position: FOUNDER / STEWARD
Credential: MS, RDN, LD
Phone: 330-873-1918