Jaclyn Powell Nutrition, Llc | |
160 Spring Meadow Ln Keswick VA 22947-3251 | |
(720) 341-5598 | |
Not Available |
Full Name | Jaclyn Powell Nutrition, Llc |
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Speciality | Clinic/center |
Location | 160 Spring Meadow Ln, Keswick, Virginia |
Authorized Official Name and Position | Jaclyn Powell (OWNER/RD) |
Authorized Official Contact | 7203415598 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jaclyn Powell Nutrition, Llc 160 Spring Meadow Ln Keswick VA 22947-3251 Ph: () - | Jaclyn Powell Nutrition, Llc 160 Spring Meadow Ln Keswick VA 22947-3251 Ph: (720) 341-5598 |
NPI Number | 1366167702 |
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Provider Enumeration Date | 10/07/2022 |
Last Update Date | 10/07/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366167702 | NPI | - | NPPES |
1699223941 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |