Provider Demographics
NPI:1750875241
Name:ALTITUDE NUTRITION AND EXERCISE CONSULTING LLC
Entity type:Organization
Organization Name:ALTITUDE NUTRITION AND EXERCISE CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:HOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-445-8565
Mailing Address - Street 1:201 S BLAKELY ST STE 133
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2203
Mailing Address - Country:US
Mailing Address - Phone:570-445-8565
Mailing Address - Fax:
Practice Address - Street 1:426 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:PA
Practice Address - Zip Code:18641-1421
Practice Address - Country:US
Practice Address - Phone:570-445-8565
Practice Address - Fax:570-561-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty