| Essential Nutrition, Inc | |
|
4730 Walnut St Suite 212 Boulder CO 80301-2558 | |
| (303) 725-4343 | |
| (303) 546-0047 |
| Full Name | Essential Nutrition, Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 4730 Walnut St, Boulder, Colorado |
| Authorized Official Name and Position | Lisa Marie High (PRESIDENT) |
| Authorized Official Contact | 3037254343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Nutrition, Inc 4730 Walnut St Suite 212 Boulder CO 80301-2558 Ph: (303) 725-4343 | Essential Nutrition, Inc 4730 Walnut St Suite 212 Boulder CO 80301-2558 Ph: (303) 725-4343 |
| NPI Number | 1104043553 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104043553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 838488 (Colorado) | Primary |
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