Provider Demographics
NPI:1487458691
Name:IRIS NUTRITION LLC
Entity type:Organization
Organization Name:IRIS NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANNERY
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:937-206-2243
Mailing Address - Street 1:5691 NEW BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-9437
Mailing Address - Country:US
Mailing Address - Phone:937-206-2243
Mailing Address - Fax:
Practice Address - Street 1:5691 NEW BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-9437
Practice Address - Country:US
Practice Address - Phone:937-705-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty