Healthcare Provider Details
I. General information
NPI: 1497306500
Provider Name (Legal Business Name): SPRING NUTRITION & WELLNESS COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3131 COLLEGE HEIGHTS BLVD STE 2400
ALLENTOWN PA
18104-4817
US
IV. Provider business mailing address
5265 ROCKROSE LN BLDG E15
ALLENTOWN PA
18104-8248
US
V. Phone/Fax
- Phone: 610-432-7733
- Fax:
- Phone: 570-972-6558
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHLEEN
JONES
Title or Position: OWNER AND ONLY MEMBER
Credential: LDN
Phone: 570-972-6558