Healthcare Provider Details

I. General information

NPI: 1386520732
Provider Name (Legal Business Name): LULO NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 N ILLINOIS ST
ARLINGTON VA
22205-1140
US

IV. Provider business mailing address

628 N ILLINOIS ST
ARLINGTON VA
22205-1140
US

V. Phone/Fax

Practice location:
  • Phone: 864-905-2925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MRS. LIZENIA PAZMIN
Title or Position: DIEITIAN
Credential: RDN
Phone: 864-905-2925