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General NPI Number Information
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NPI Number | 1760827984
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Entity Type | Organization
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Legal Business Name | RMR WEIGHT MANAGEMENT
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 4058 W WILSON RD
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City | CLIO
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State | MI
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Zip | 48420-9481
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Country | US
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Telephone | 810-444-2749
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Fax |
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Provider Business Mailing Address
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Address Line | 10242 SHARP RD
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City | SWARTZ CREEK
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State | MI
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Zip | 48473-9156
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Country | US
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Telephone | 810-444-2749
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MR. WAEL AWAD SAMARAH
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Credential | BS, ALCS,BS
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Telephone | 810-444-2749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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