| Live Nutrition Inc | |
|
26 Wampum Dr, Brewster, MA 02631-1956 | |
| (508) 896-9080 | |
| (508) 896-3399 |
| Full Name | Live Nutrition Inc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 26 Wampum Dr, Brewster, Massachusetts |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548221682 | NPI | - | NPPES |
| NU445 | Other | MA | MASSACHUSETTS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | NU445 (Massachusetts) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Live Nutrition Inc 26 Wampum Dr, Po Box 1709, Brewster, MA 02631-1956 Ph: (508) 896-9080 | Live Nutrition Inc 26 Wampum Dr, Brewster, MA 02631-1956 Ph: (508) 896-9080 |
Mrs. Margaret Davis, MS,RD,LDN,FADA,CDE Dietitian Medicare: Medicare Enrolled Practice Location: 26 Wampum Dr, Brewster, MA 02631 Phone: 508-896-9080 Fax: 508-896-3399 | |
Miss Rachel Dyer Pernick, R.D Dietitian Medicare: Not Enrolled in Medicare Practice Location: 26 Wampum Dr, Brewster, MA 02631 Phone: 508-896-9080 | |
Mrs. Abigail Usen Berner, MS, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 26 Wampum Dr, Brewster, MA 02631 Phone: 508-896-9080 | |
Ms. Courtney Rose Driscoll, RD LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 26 Wampum Drive, Brewster, MA 02631 Phone: 508-896-9080 Fax: 508-896-3399 |