Healthcare Provider Details

I. General information

NPI: 1649981200
Provider Name (Legal Business Name): DAILY HABITS NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 ZION PARK BLVD
SPRINGDALE UT
84767-7765
US

IV. Provider business mailing address

1013 E OLYMPUS RIDGE CV APT C106
SALT LAKE CITY UT
84117-3306
US

V. Phone/Fax

Practice location:
  • Phone: 801-719-1180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MALLORY SPENDLOVE
Title or Position: OWNER
Credential: RDN, MDA
Phone: 801-719-1180