| Jaclyn Powell Nutrition, Llc | |
|
160 Spring Meadow Ln Keswick VA 22947-3251 | |
| (720) 341-5598 | |
| Not Available |
| Full Name | Jaclyn Powell Nutrition, Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |