| Fitventures Pewaukee Inc | |
|
1450 Capitol Dr Unit C, Pewaukee, WI 53072-2608 | |
| (262) 347-1843 | |
| (855) 978-2028 |
| Full Name | Fitventures Pewaukee Inc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 1450 Capitol Dr Unit C, Pewaukee, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962379792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (NU) | Primary |
| Provider Name | Jayden Mae Clemetson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487381778 PECOS PAC ID: 2769950062 Enrollment ID: I20260505004151 |
| Mailing Address | Practice Location Address |
|---|---|
| Fitventures Pewaukee Inc 1450 Capitol Dr Unit C, Pewaukee, WI 53072-2608 Ph: (262) 347-1843 | Fitventures Pewaukee Inc 1450 Capitol Dr Unit C, Pewaukee, WI 53072-2608 Ph: (262) 347-1843 |
Mrs. Ellen Marie Rasch, MS,RD,CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: W243n2755 Creekside Dr, Pewaukee, WI 53072 Phone: 262-902-5654 |
Mrs. Teri A Krier, RD, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: N17w26538 Meadowgrass Cir Unit F, Pewaukee, WI 53072 Phone: 920-819-2280 |
Bethany Waala, RDN, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: N23w25025 Valleyview Ln, Pewaukee, WI 53072 Phone: 920-740-0611 |
Marie Dittmer, MA, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: N42w22832 Beacon Ct, Pewaukee, WI 53072 Phone: 262-422-2390 |