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NPI Code Detail

MEDICARE: HAPPY TRAILS NUTRITION L.L.C.

MEDICARE: HAPPY TRAILS NUTRITION L.L.C.
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
1261QM2500XMedical Specialty Clinic/Center

General Provider Information

NPI Number : 1578386595
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAPPY TRAILS NUTRITION L.L.C.
Provider Business Mailing Address
First Line : 108 N MAIN ST
Second Line :
City : WHITE RIVER JUNCTION
State : VT
Zip : 05001-7056
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 108 N MAIN ST
Second Line :
City : WHITE RIVER JUNCTION
State : VT
Zip : 05001-7056
Country : US
Telephone Number : 603-802-3988
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JENNIFER MEIJER
Credential : PHD, RD
Telephone Number : 603-802-3988
Provider Enumeration Date : 11/07/2024
Last Update Date : 11/19/2024

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Directions to “HAPPY TRAILS NUTRITION L.L.C. ” Practice Location

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