Provider Demographics
NPI:1760223622
Name:DIET VS DISEASE LLC
Entity type:Organization
Organization Name:DIET VS DISEASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHNENSTIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:660-620-2755
Mailing Address - Street 1:19618 S QUAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-9306
Mailing Address - Country:US
Mailing Address - Phone:660-620-2755
Mailing Address - Fax:
Practice Address - Street 1:19618 S QUAIL RIDGE RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-9306
Practice Address - Country:US
Practice Address - Phone:660-620-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty