Provider Demographics
NPI:1124504592
Name:MEREDITH A BIGGART DBA ROOT NUTRITION
Entity type:Organization
Organization Name:MEREDITH A BIGGART DBA ROOT NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIGGART
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:978-314-1995
Mailing Address - Street 1:4 BUXTON RD
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1320
Mailing Address - Country:US
Mailing Address - Phone:978-314-1995
Mailing Address - Fax:
Practice Address - Street 1:110 NEWBURY ST STE E
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-5209
Practice Address - Country:US
Practice Address - Phone:978-314-1995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU4570133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty