| Soco Nutrition, Llc | |
|
943 Short St, Canon City, CO 81212-4256 | |
| (719) 426-1899 | |
| Not Available |
| Full Name | Soco Nutrition, Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 943 Short St, Canon City, Colorado |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336731371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Soco Nutrition, Llc 943 Short St, Canon City, CO 81212-4256 Ph: (719) 426-1899 | Soco Nutrition, Llc 943 Short St, Canon City, CO 81212-4256 Ph: (719) 426-1899 |
Anna Kristin Payne, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 943 Short St, Canon City, CO 81212 Phone: 719-426-1899 | |
Mr. Dave Earl Egerdahl, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1338 Phay Ave, Canon City, CO 81212 Phone: 719-285-2025 Fax: 719-285-2277 | |
Miriam Loomis, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1338 Phay Ave, Canon City, CO 81212 Phone: 719-285-2548 | |
Mrs. Tenisha D Tavares, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1338 Phay Ave, Canon City, CO 81212 Phone: 719-285-2025 | |
Mrs. Christine Nicole Lewis, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1338 Phay Ave, Canon City, CO 81212 Phone: 719-285-2034 Fax: 719-285-2277 |