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General NPI Number Information
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NPI Number | 1003750001
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Entity Type | Organization
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Legal Business Name | HEALTHY BY KELSEY NUTRITION COLLECTIVE LLC
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Dates
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Enumeration Date | 04/18/2026
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Last Update Date | 04/18/2026
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Provider Practice Location Address
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Address Line | 3091 COUNTRY CLUB RD
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City | SAN ANGELO
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State | TX
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Zip | 76904-9396
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Country | US
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Telephone | 325-656-5873
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Fax |
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Provider Business Mailing Address
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Address Line | 3091 COUNTRY CLUB RD
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City | SAN ANGELO
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State | TX
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Zip | 76904-9396
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | KELSEY WALLING
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Credential |
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Telephone | 325-656-5873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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