Provider Demographics
NPI:1396247433
Name:CHESTER COUNTY NUTRITION & WEIGHT MANAGEMENT LLC
Entity type:Organization
Organization Name:CHESTER COUNTY NUTRITION & WEIGHT MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD,LDN
Authorized Official - Phone:610-518-5253
Mailing Address - Street 1:107 SYCAMORE SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4514
Mailing Address - Country:US
Mailing Address - Phone:610-518-5253
Mailing Address - Fax:610-590-2216
Practice Address - Street 1:107 SYCAMORE SPRINGS LN
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-4514
Practice Address - Country:US
Practice Address - Phone:610-518-5253
Practice Address - Fax:610-590-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002928133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty