Provider Demographics
NPI:1063155109
Name:RAYNOR STRENGTH AND NUTRITION, LLC
Entity type:Organization
Organization Name:RAYNOR STRENGTH AND NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:HURLEY
Authorized Official - Last Name:RAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN, CSCS
Authorized Official - Phone:919-675-8503
Mailing Address - Street 1:1441 E BROAD ST STE 256
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-1968
Mailing Address - Country:US
Mailing Address - Phone:919-741-0730
Mailing Address - Fax:
Practice Address - Street 1:1441 E BROAD ST STE 256
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1968
Practice Address - Country:US
Practice Address - Phone:919-741-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty