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General NPI Number Information
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NPI Number | 1235824400
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Entity Type | Organization
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Legal Business Name | ALIGNED EATS LLC
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 23 N GORE AVE STE 210
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-2300
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Country | US
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Telephone | 314-806-7655
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Fax |
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Provider Business Mailing Address
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Address Line | 269 PALM DR
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City | HAZELWOOD
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State | MO
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Zip | 63042-2114
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Country | US
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Telephone | 314-497-3367
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LAURA RUSSELL
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Credential | RDN, LD
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Telephone | 314-497-3367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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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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