Provider Demographics
NPI:1801590179
Name:AURIC NUTRITION & WELLNESS
Entity type:Organization
Organization Name:AURIC NUTRITION & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MSRDN
Authorized Official - Phone:415-723-1444
Mailing Address - Street 1:2110 HOLLOW BROOK DR # 104
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1444
Mailing Address - Country:US
Mailing Address - Phone:415-723-1444
Mailing Address - Fax:
Practice Address - Street 1:2110 HOLLOW BROOK DR # 104
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1444
Practice Address - Country:US
Practice Address - Phone:415-723-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty