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General NPI Number Information
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NPI Number | 1174277271
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Entity Type | Organization
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Legal Business Name | MELINDA BENZ LLC
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 1751 HOVER ST STE B4 #84
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City | LONGMONT
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State | CO
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Zip | 80501
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Country | US
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Telephone | 719-347-1310
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Fax |
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Provider Business Mailing Address
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Address Line | 1751 HOVER ST STE B4
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City | LONGMONT
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State | CO
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Zip | 80501-7181
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Country | US
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Telephone | 720-340-8048
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MELINDA BENZ
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Credential | RDN
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Telephone | 720-340-8048
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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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