| Summit Performance Nutrition Llc | |
|
6156 Rockville Dr, Colorado Springs, CO 80923-3806 | |
| (719) 684-5754 | |
| Not Available |
| Full Name | Summit Performance Nutrition Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 6156 Rockville Dr, Colorado Springs, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003370115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Jenna Denise Moore-liester |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538655097 PECOS PAC ID: 4688914401 Enrollment ID: I20190314000381 |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Performance Nutrition Llc 6156 Rockville Dr, Colorado Springs, CO 80923-3806 Ph: (719) 684-5754 | Summit Performance Nutrition Llc 6156 Rockville Dr, Colorado Springs, CO 80923-3806 Ph: (719) 684-5754 |
Nadine Carlile, RD Dietitian Medicare: Medicare Enrolled Practice Location: 3027 N Circle Dr, Colorado Springs, CO 80909 Phone: 719-776-4646 | |
Ridgeline Dietetics Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3718 Red Canon Pl, Colorado Springs, CO 80904 Phone: 612-723-0735 | |
Michelle Archuleta, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 7240 Brentford Dr, Colorado Springs, CO 80919 Phone: 719-351-9671 | |
Kenneth Richard Cook, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3030 N Circle Dr Ste 301, Colorado Springs, CO 80909 Phone: 719-475-9574 | |
Synergy Nutrition Counseling Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2035 Bula Dr, Colorado Springs, CO 80915 Phone: 612-367-6572 | |
Mrs. Rebecca Stauffer, MA, RD, LPCC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 25 N Wahsatch Ave Ste 204, Colorado Springs, CO 80903 Phone: 719-351-0892 |