NPI 1902439508 · live from the CMS NPI Registry
Wonderfully Well LLC
Dietitian, Registered in Gillette, WY. National Provider Identifier 1902439508, active.
NPI record
| NPI | 1902439508 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2001 W Lakeway Rd Ste E, Gillette, WY 82718 |
| Practice phone | 307-710-6790 |
| Mailing address | Po Box 3944, Gillette, WY 82717 |
| Enumerated | February 21, 2020 |
| Last updated | February 21, 2020 |
| Authorized official | Jamie Marchetti, Dietitian/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.