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General NPI Number Information
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NPI Number | 1578386595
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Entity Type | Organization
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Legal Business Name | HAPPY TRAILS NUTRITION L.L.C.
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 108 N MAIN ST
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05001-7056
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Country | US
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Telephone | 603-802-3988
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Fax |
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Provider Business Mailing Address
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Address Line | 108 N MAIN ST
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05001-7056
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MEIJER
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Credential | PHD, RD
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Telephone | 603-802-3988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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