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General NPI Number Information
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NPI Number | 1578077616
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Entity Type | Organization
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Legal Business Name | OCEAN CITY NUTRITION
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 7040 MORRIS RD
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City | PITTSVILLE
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State | MD
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Zip | 21850-2188
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Country | US
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Telephone | 443-557-8411
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Fax |
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Provider Business Mailing Address
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Address Line | 301 BROOKVIEW DR
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City | SALISBURY
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State | MD
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Zip | 21804-3907
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Country | US
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Telephone | 443-557-8411
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Fax |
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Authorized Official
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Title or Position | CERTIFIED NUTRITION SPECIALIST
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Name | SARAH BRICE KLAVERWEIDEN
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Credential | CNS
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Telephone | 443-557-8411
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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 | CNS17179
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License Number State | MD
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