Organization · Type 2 NPI
One Source Nutrition, LLC
Health Service Clinic/Center · Norwalk, CT
NPI number
1871504142
Active
Practice location
301 Merritt 7, Wellness Center
Norwalk, CT 06851-1070
Fax (203) 604-0204
Mailing address
668 Glenbrook Rd Apt 33
Stamford, CT 06906-1434
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center Primary | 261QH0100X | 000764 (CT) |
Health Service Clinic/Center: Definition to come...
2 other providers at this address
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About NPI 1871504142
One Source Nutrition, LLC's National Provider Identifier is 1871504142, issued on Aug 11, 2006. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Norwalk, CT. The record was last updated on Aug 22, 2020.