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General NPI Number Information
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NPI Number | 1407332356
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Entity Type | Organization
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Legal Business Name | CHELSEA EDWARDS NUTRITION LLC
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 7738B MADISON BLVD STE 204
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City | HUNTSVILLE
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State | AL
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Zip | 35806
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Country | US
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Telephone | 256-224-1665
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Fax | 833-629-8753
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Provider Business Mailing Address
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Address Line | 7738B MADISON BLVD STE 204
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City | HUNTSVILLE
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State | AL
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Zip | 35806-3661
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Country | US
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Telephone | 256-224-1665
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Fax | 833-629-8753
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA EDWARDS
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Credential | RDN, LD
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Telephone | 256-783-9530
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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 | 2822
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License Number State | AL
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