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General NPI Number Information
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NPI Number | 1720286420
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Entity Type | Organization
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Legal Business Name | NUTRITION REALITY LLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 3690 ORANGE PL SUITE 230
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City | BEACHWOOD
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State | OH
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Zip | 44122-4464
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Country | US
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Telephone | 440-349-3873
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Fax | 440-349-5878
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Provider Business Mailing Address
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Address Line | 32700 S ROUNDHEAD DR
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City | SOLON
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State | OH
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Zip | 44139-4738
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Country | US
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Telephone | 440-349-2280
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Fax | 440-349-5878
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANE E KORSBERG
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Credential | MS, RD, LD
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Telephone | 440-349-3873
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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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