| Optimal Plan Nutrition, Llc. | |
|
145 Governors Sq Ste A Peachtree City GA 30269-4861 | |
| (404) 509-1195 | |
| Not Available |
| Full Name | Optimal Plan Nutrition, Llc. |
|---|---|
| Speciality | Dietitian, Registered |
| Location | 145 Governors Sq Ste A, Peachtree City, Georgia |
| Authorized Official Name and Position | Gregory Lafortune (OWNER) |
| Authorized Official Contact | 4045091195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Plan Nutrition, Llc. 947 Salisbury Trl Riverdale GA 30296-1549 Ph: (404) 509-1195 | Optimal Plan Nutrition, Llc. 145 Governors Sq Ste A Peachtree City GA 30269-4861 Ph: (404) 509-1195 |
| NPI Number | 1902566557 |
|---|---|
| Provider Enumeration Date | 12/22/2021 |
| Last Update Date | 10/31/2023 |
| Certification Date | 08/08/2023 |
| Medicare PECOS PAC ID | 6406202100 |
|---|---|
| Medicare Enrollment ID | O20231101002569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902566557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Gregory Lafortune |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1730849381 PECOS PAC ID: 7214383918 Enrollment ID: I20231101002696 |
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