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General NPI Number Information
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NPI Number | 1326994922
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Entity Type | Organization
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Legal Business Name | THE RECOVERY NUTRITIONIST, LLC
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 204 MEADOW RIDGE ACRES RD
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City | MILFORD
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State | PA
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Zip | 18337-7805
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Country | US
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Telephone | 845-747-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 204 MEADOW RIDGE ACRES RD
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City | MILFORD
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State | PA
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Zip | 18337-7805
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Country | US
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Telephone | 845-747-0789
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KYLE ELY WOLFE
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Credential | MSACN, CDN, LDN
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Telephone | 914-799-2023
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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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