Healthcare Provider Details

I. General information

NPI: 1871498907
Provider Name (Legal Business Name): J LANG NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 OLD YORK RD
ELKINS PARK PA
19027-3005
US

IV. Provider business mailing address

7401 OLD YORK RD
ELKINS PARK PA
19027-3005
US

V. Phone/Fax

Practice location:
  • Phone: 267-693-6333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: JELISA SMITH
Title or Position: PRESIDENT
Credential:
Phone: 267-693-6333