| Nutritionally Yours LLC | |
|
1112 Ladowick Ln Wake Forest NC 27587-5584 | |
| (919) 426-6956 | |
| (919) 300-8913 |
| Full Name | Nutritionally Yours LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1112 Ladowick Ln, Wake Forest, North Carolina |
| Authorized Official Name and Position | Manjushree Karkare (OWNER) |
| Authorized Official Contact | 9194266956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nutritionally Yours LLC 1112 Ladowick Ln Wake Forest NC 27587-5584 Ph: (919) 426-6956 | Nutritionally Yours LLC 1112 Ladowick Ln Wake Forest NC 27587-5584 Ph: (919) 426-6956 |
| NPI Number | 1376914853 |
|---|---|
| Provider Enumeration Date | 10/09/2015 |
| Last Update Date | 04/14/2023 |
| Certification Date | 04/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376914853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | L001824 (North Carolina) | Primary |
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