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General NPI Number Information
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NPI Number | 1215551742
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Entity Type | Organization
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Legal Business Name | EAT WELL NUTRITION LLC
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 95 ALLENS CREEK RD STE 202
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City | ROCHESTER
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State | NY
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Zip | 14618-3245
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Country | US
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Telephone | 585-210-2644
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Fax | 866-877-2844
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Provider Business Mailing Address
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Address Line | 114 W IVY ST
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City | EAST ROCHESTER
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State | NY
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Zip | 14445-1816
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Country | US
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Telephone | 585-210-2644
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Fax | 866-877-2844
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH M WOODWORTH
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Credential | RD
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Telephone | 585-210-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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