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General NPI Number Information
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NPI Number | 1972449445
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Entity Type | Organization
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Legal Business Name | UNIQUELYU FUNCTIONAL NUTRITION, LLC
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 2909 ROLLING OAKS DR
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-4161
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Country | US
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Telephone | 214-813-9966
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Fax |
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Provider Business Mailing Address
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Address Line | 2909 ROLLING OAKS DR
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-4161
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Country | US
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Telephone | 214-813-9966
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMIE WILLS
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Credential | MS, RD, LD
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Telephone | 214-813-9966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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