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General NPI Number Information
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NPI Number | 1255633236
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Entity Type | Organization
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Legal Business Name | NUTRITION DIMENSIONS INC
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 2609 FANCY FARM RD
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City | BEDFORD
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State | VA
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Zip | 24523-3363
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Country | US
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Telephone | 540-586-4111
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Fax | 888-875-6054
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Provider Business Mailing Address
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Address Line | 2609 FANCY FARM RD
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City | BEDFORD
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State | VA
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Zip | 24523-3363
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Country | US
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Telephone | 540-586-4111
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Fax | 888-875-6054
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTHA MCDANIEL SLAUGHTER
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Credential | RD, LD, FADA, FACHE
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Telephone | 540-586-4111
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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 | DT05674
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License Number State | TX
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