=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033945183
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EATRIGHTFITNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2024
-----------------------------------------------------
Last Update Date | 09/13/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 118 W STREETSBORO ST STE 5-216
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44236-2752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-289-7215
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 118 W STREETSBORO ST STE 5-216
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44236-2752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-289-7215
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ROGER E ADAMS
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 214-289-7215
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133NN1002X
-----------------------------------------------------
Taxonomy Name | Nutrition Education Nutritionist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171400000X
-----------------------------------------------------
Taxonomy Name | Health & Wellness Coach
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 174H00000X
-----------------------------------------------------
Taxonomy Name | Health Educator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------