Deep Well Collective
Organization Active NPI Nutritionist · Afton, VA
NPI 1669210969 · NPPES record last updated Jul 19, 2024
Key facts
- NPI
- 1669210969
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nutritionist 133N00000X
- Legal business name
- DEEP WELL COLLECTIVE
- Practice address
- 2071 Afton Mountain Rd
Afton, VA 22920-2308 - Phone
- (434) 326-8635
- NPI assigned
- Jul 19, 2024
- Organization subpart
- No
Authorized official
- Name
- Dr. Ryan D Hall, DCN, CNS, LDN
- Title
- Ceo
- Phone
- (434) 326-8635
Practitioners 1
-
Ryan D Hall, DCN,CNS, LDN
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist |
133N00000X | Yes | ||
| Nutrition Education Nutritionist |
133NN1002X | |||
| Registered Dietitian |
133V00000X | |||
| Metabolic Nutrition Registered Dietitian |
133VN1006X | |||
| Obesity and Weight Management Nutrition Registered Dietitian |
133VN1201X | |||
| Oncology Nutrition Registered Dietitian |
133VN1301X | |||
| Sports Dietetics Nutrition Registered Dietitian |
133VN1501X |
Addresses
Primary practice location
2071 Afton Mountain Rd
Afton, VA 22920-2308
Mailing address
2071 Afton Mountain Rd
Afton, VA 22920-2308
Phone (434) 326-8635
Other names
- Deep Well Collective
Other providers in Afton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.