Healthcare Provider Details

I. General information

NPI: 1578974986
Provider Name (Legal Business Name): TRIMLINE WEIGHT LOSS CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 BOSLER AVE
LEMOYNE PA
17043-1931
US

IV. Provider business mailing address

406 BOSLER AVE
LEMOYNE PA
17043-1931
US

V. Phone/Fax

Practice location:
  • Phone: 717-737-4292
  • Fax:
Mailing address:
  • Phone: 717-737-4292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: ZAHRA NADIA SHARIFI
Title or Position: OWNER/OPERATOR
Credential:
Phone: 717-982-7181