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General NPI Number Information
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NPI Number | 1972426096
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Entity Type | Organization
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Legal Business Name | GUT THEORY TOTAL DIGESTIVE CARE LLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 5225 WISCONSIN AVE NW STE 200B
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City | WASHINGTON
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State | DC
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Zip | 20015-2014
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Country | US
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Telephone | 888-755-4881
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Fax | 888-755-4881
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Provider Business Mailing Address
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Address Line | 5225 WISCONSIN AVE NW STE 200B
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City | WASHINGTON
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State | DC
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Zip | 20015-2014
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Country | US
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Telephone | 888-755-4881
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Fax | 888-755-4881
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Authorized Official
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Title or Position | OWNER/CEO
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Name | JANESE SHADE' LASTER-BUTLER
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Credential | MD
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Telephone | 888-755-4881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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