Provider Demographics
NPI:1326875139
Name:BRITT'S PERFORMANCE NUTRITION
Entity type:Organization
Organization Name:BRITT'S PERFORMANCE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPORTS DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CSSD
Authorized Official - Phone:612-772-4057
Mailing Address - Street 1:643 N PRINCE HENRY WAY
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-5000
Mailing Address - Country:US
Mailing Address - Phone:612-772-4057
Mailing Address - Fax:
Practice Address - Street 1:643 N PRINCE HENRY WAY
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-5000
Practice Address - Country:US
Practice Address - Phone:612-772-4057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered