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General NPI Number Information
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NPI Number | 1073426854
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN DIETETICS LLC
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 23858 US HIGHWAY 98 STE F
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City | FAIRHOPE
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State | AL
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Zip | 36532-3480
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Country | US
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Telephone | 251-421-0814
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Fax |
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Provider Business Mailing Address
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Address Line | 23858 US HIGHWAY 98 STE F
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City | FAIRHOPE
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State | AL
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Zip | 36532-3480
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Country | US
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Telephone | 251-421-0814
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN THRASHER
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Credential | MS, RDN, LD
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Telephone | 251-421-0814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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