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General NPI Number Information
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NPI Number | 1083961429
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Entity Type | Organization
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Legal Business Name | WEIGHT NO LONGER, LLC
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Dates
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Enumeration Date | 08/03/2012
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 114 CANAL ST SUITE 501
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City | POOLER
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State | GA
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Zip | 31322-4153
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Country | US
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Telephone | 912-450-8100
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Fax | 912-450-8002
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Provider Business Mailing Address
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Address Line | 114 CANAL ST SUITE 501
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City | POOLER
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State | GA
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Zip | 31322-4153
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Country | US
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Telephone | 912-450-8100
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Fax | 912-450-8002
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Authorized Official
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Title or Position | MANAGER
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Name | MR. OLIVER BRAUN
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Credential |
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Telephone | 912-450-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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