Healthcare Provider Details

I. General information

NPI: 1730772906
Provider Name (Legal Business Name): REDISCOVER HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 OLDE MAIN PLZ
SAINT ALBANS WV
25177-2707
US

IV. Provider business mailing address

853 VINE ST
SAINT ALBANS WV
25177-3271
US

V. Phone/Fax

Practice location:
  • Phone: 304-729-4117
  • Fax: 304-407-7557
Mailing address:
  • Phone: 304-356-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE LANHAM
Title or Position: OWNER/NUTRITIONIST
Credential: CNS, NBC-HWC
Phone: 304-356-6617