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General NPI Number Information
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NPI Number | 1477362648
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Entity Type | Organization
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Legal Business Name | ADVANCED NUTRITION CARE, LLC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1517 PRAIRIE VISTA DR
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City | CHATHAM
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State | IL
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Zip | 62629-5095
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Country | US
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Telephone | 812-204-8110
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 PRAIRIE VISTA DR
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City | CHATHAM
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State | IL
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Zip | 62629-5095
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Country | US
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Telephone | 812-204-8110
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATE HORSTMEYER
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Credential | RD, LDN
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Telephone | 812-204-8110
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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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