Healthcare Provider Details

I. General information

NPI: 1992507297
Provider Name (Legal Business Name): TEAMWORK NUTRITION AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5213 MANDORA CT
NORTH CHESTERFIELD VA
23237-2476
US

IV. Provider business mailing address

5213 MANDORA CT
NORTH CHESTERFIELD VA
23237-2476
US

V. Phone/Fax

Practice location:
  • Phone: 804-721-4696
  • Fax:
Mailing address:
  • Phone: 804-721-4696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MR. MURRAY KINCH WOOD
Title or Position: OWNER, FOUNDER
Credential: RDN
Phone: 804-721-4696