Advanced Nutrition, LLC

Organization Active NPI Registered Dietitian · Waltham, MA

NPI 1174947253 · NPPES record last updated Feb 11, 2014

Key facts

NPI
1174947253
Entity type
Organization (NPI type 2)
Primary specialty
Registered Dietitian 133V00000X
License
2334 (MA)
Legal business name
ADVANCED NUTRITION, LLC
Practice address
32 South St
Unit 300
Waltham, MA 02453-3594
Phone
(781) 642-1250
Fax
(781) 207-6415
NPI assigned
Feb 11, 2014
Organization subpart
No

Authorized official

Name
Adam Laferriere, PA
Title
Co-Owner
Phone
(781) 642-1250

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

32 South St
Ste 300
Waltham, MA 02453
Phone (781) 642-1250

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193400000X SINGLE SPECIALTY GROUP
133V00000X 2334 MA Yes

Addresses

Primary practice location

32 South St
Unit 300
Waltham, MA 02453-3594

Mailing address

32 South St
Unit 300
Waltham, MA 02453-3594
Phone (781) 642-1250

Other providers in Waltham, MA

All providers in Waltham, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.