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General NPI Number Information
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NPI Number | 1902491921
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Entity Type | Organization
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Legal Business Name | NUTRIPLEXITY LLC
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 2020 SHAMROCK DR. NW
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City | BREMERTON
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State | WA
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Zip | 98312
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Country | US
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Telephone | 979-703-9608
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 SHAMROCK DR. NW
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City | BREMERTON
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State | WA
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Zip | 98312
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Country | US
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Telephone | 979-703-9608
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EMILY ELIZABETH BROWN REEVES
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Credential | PHD CNS
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Telephone | 979-703-9608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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