Provider Demographics
NPI:1588308977
Name:DIETITIANS ON DEMAND, LLC
Entity type:Organization
Organization Name:DIETITIANS ON DEMAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:804-306-0886
Mailing Address - Street 1:7814 CAROUSEL LN STE 210
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4212
Mailing Address - Country:US
Mailing Address - Phone:804-545-9162
Mailing Address - Fax:
Practice Address - Street 1:7814 CAROUSEL LN STE 210
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4212
Practice Address - Country:US
Practice Address - Phone:804-545-9162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty