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NPI Code Detail

MEDICARE: REAL LIFE FUEL, LLC

MEDICARE: REAL LIFE FUEL, 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
1133VN1501XSports Dietetics Nutrition Registered Dietitian

General Provider Information

NPI Number : 1447104187
Entity Type Code : Organization
Provider Name (Legal Business Name) : REAL LIFE FUEL, LLC
Provider Business Mailing Address
First Line : 906 PLEASANT RIDGE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43209-2430
Country : US
Telephone Number : 614-441-6872
Fax Number : 614-533-6609
Provider Business Practice Location Address
First Line : 3705 OLENTANGY RIVER RD STE 260
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-3467
Country : US
Telephone Number : 614-441-6872
Fax Number : 614-533-6609
Authorized Official
Title or Position : SPORTS DIETITIAN
Name : DAWN HOLMES
Credential : MS, RD, LD, CSSD
Telephone Number : 614-441-6872
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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Directions to “REAL LIFE FUEL, LLC ” Practice Location

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