| The Nutrition Clinic Llc | |
|
200 Research Dr Manhattan KS 66503-3049 | |
| (785) 236-9607 | |
| Not Available |
| Full Name | The Nutrition Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Research Dr, Manhattan, Kansas |
| Authorized Official Name and Position | Jordan Amanda Chen (DIETITIAN) |
| Authorized Official Contact | 7852369607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Nutrition Clinic Llc 2213 Woodridge Dr Manhattan KS 66503-7609 Ph: (785) 236-9607 | The Nutrition Clinic Llc 200 Research Dr Manhattan KS 66503-3049 Ph: (785) 236-9607 |
| NPI Number | 1932709524 |
|---|---|
| Provider Enumeration Date | 11/01/2020 |
| Last Update Date | 11/01/2020 |
| Medicare PECOS PAC ID | 8325454960 |
|---|---|
| Medicare Enrollment ID | O20210308000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932709524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jordan A Chen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1518458504 PECOS PAC ID: 3274863352 Enrollment ID: I20191003000479 |
| Provider Name | Ella Caroline Koss |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780331421 PECOS PAC ID: 5092101402 Enrollment ID: I20220412002902 |
| Provider Name | Elizabeth Eileen Daniels |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528793403 PECOS PAC ID: 6709260805 Enrollment ID: I20220908000276 |
| Provider Name | Kate Larosh |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679260301 PECOS PAC ID: 7113371915 Enrollment ID: I20230927003802 |
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