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General NPI Number Information
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NPI Number | 1366062010
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Entity Type | Organization
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Legal Business Name | HEALTHY WEIGHT NUTRITION
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 5361 MEADOW BROOK RD
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City | BIRMINGHAM
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State | AL
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Zip | 35242-3340
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Country | US
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Telephone | 205-213-0410
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Fax | 251-299-4030
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Provider Business Mailing Address
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Address Line | 5361 MEADOW BROOK RD
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City | BIRMINGHAM
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State | AL
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Zip | 35242-3340
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Country | US
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Telephone | 205-213-0410
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Fax | 251-299-4030
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Authorized Official
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Title or Position | REGISTERED DIETITIAN/ OWNER
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Name | KELLY WEST KEYSER
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Credential | MS, RD, LD, CDE
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Telephone | 205-213-0410
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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 |
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License Number State |
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