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General NPI Number Information
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NPI Number | 1396260485
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Entity Type | Organization
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Legal Business Name | NUTRITION CENTER OF COLORADO, LLC
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7760 E PEAKVIEW AVE APT 211
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City | CENTENNIAL
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State | CO
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Zip | 80111-6888
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Country | US
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Telephone | 201-647-0907
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Fax |
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Provider Business Mailing Address
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Address Line | 7760 E PEAKVIEW AVE APT 211
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City | CENTENNIAL
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State | CO
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Zip | 80111-6888
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Country | US
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Telephone | 201-647-0907
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINE PATORNITI
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Credential | RD, CDE, MBA
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Telephone | 201-647-0907
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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 | 1064421
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License Number State | CO
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