Healthcare Provider Details

I. General information

NPI: 1821776311
Provider Name (Legal Business Name): ALL OF NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 S FOOTHILL DR STE 180
SALT LAKE CITY UT
84109-5403
US

IV. Provider business mailing address

2319 S FOOTHILL DR STE 180
SALT LAKE CITY UT
84109-5403
US

V. Phone/Fax

Practice location:
  • Phone: 385-722-4393
  • Fax: 833-296-7437
Mailing address:
  • Phone: 385-722-4393
  • Fax: 833-296-7437

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
# 3
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MARYSA ANDERSON-CARDWELL
Title or Position: OWNER/RDN
Credential: MS, RDN
Phone: 385-722-4393