Provider Demographics
NPI:1093535296
Name:KLAMMER NUTRITION LLC
Entity type:Organization
Organization Name:KLAMMER NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:316-832-8064
Mailing Address - Street 1:309 S LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-2135
Mailing Address - Country:US
Mailing Address - Phone:316-832-8064
Mailing Address - Fax:
Practice Address - Street 1:309 S LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-2135
Practice Address - Country:US
Practice Address - Phone:316-832-8064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-12
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty