MEDICARE: NUTRITION FACTORY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian		MA

General Provider Information

NPI Number	:	1366718355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUTRITION FACTORY, LLC

Provider Business Mailing Address
First Line	:	565 TURNPIKE ST STE 64
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-5936
Country	:	US
Telephone Number	:	978-474-4478
Fax Number	:	978-427-6229

Provider Business Practice Location Address
First Line	:	565 TURNPIKE ST STE 64
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-5936
Country	:	US
Telephone Number	:	978-474-4478
Fax Number	:	978-427-6229

Authorized Official
Title or Position	:	CO OWNER
Name	:	SHELLEY ANN WOOLSEY
Credential	:	RD
Telephone Number	:	978-474-4478

Provider Enumeration Date	:	03/24/2012
Last Update Date	:	05/28/2024

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Directions to “NUTRITION FACTORY, LLC ” Practice Location

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