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General NPI Number Information
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NPI Number | 1306230750
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Entity Type | Organization
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Legal Business Name | BEWELL ASSOCIATES
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 233 EASTERLY PKWY 104
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City | STATE COLLEGE
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State | PA
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Zip | 16801-6300
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Country | US
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Telephone | 814-234-0785
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Fax | 814-234-0775
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Provider Business Mailing Address
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Address Line | 233 EASTERLY PKWY 104
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City | STATE COLLEGE
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State | PA
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Zip | 16801-6300
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Country | US
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Telephone | 814-234-0785
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Fax | 814-234-0775
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Authorized Official
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Title or Position | CERTIFIED NUTRITIONISTS
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Name | MONICA MONTAG
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Credential | CN
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Telephone | 814-234-0785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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