NPI 1174947253 · live from the CMS NPI Registry
Advanced Nutrition, LLC
Dietitian, Registered in Waltham, MA. National Provider Identifier 1174947253, active.
NPI record
| NPI | 1174947253 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 32 South St, Unit 300, Waltham, MA 02453 |
| Practice phone | 781-642-1250 |
| Enumerated | February 11, 2014 |
| Last updated | February 11, 2014 |
| Authorized official | Adam Laferriere, Co-Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 2334 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.