Provider Demographics
NPI:1215294988
Name:THORNTON DIETITIAN CONSULTANTS
Entity type:Organization
Organization Name:THORNTON DIETITIAN CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:BLACKWELL
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:731-676-0793
Mailing Address - Street 1:36 SANDSTONE CIR
Mailing Address - Street 2:SUITE E
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2098
Mailing Address - Country:US
Mailing Address - Phone:731-676-0793
Mailing Address - Fax:
Practice Address - Street 1:36 SANDSTONE CIR
Practice Address - Street 2:SUITE E
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2098
Practice Address - Country:US
Practice Address - Phone:731-676-0793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1348133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty