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General NPI Number Information
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NPI Number | 1194463117
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Entity Type | Organization
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Legal Business Name | SEEDS OF CHANGE NUTRITION, LLC
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Dates
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Enumeration Date | 05/20/2022
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 1189 GROVE DR
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City | GAHANNA
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State | OH
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Zip | 43230-6223
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Country | US
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Telephone | 614-446-2704
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Fax |
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Provider Business Mailing Address
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Address Line | 1189 GROVE DR
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City | GAHANNA
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State | OH
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Zip | 43230-6223
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Country | US
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Telephone | 614-446-2704
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Fax |
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Authorized Official
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Title or Position | OWNER/CERTIFIED HEALTH COACH
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Name | MS. FLORENCE E KOORS
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Credential | DTR, CHC
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Telephone | 614-446-2704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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