Provider Demographics
NPI:1598599102
Name:PAVUK, CHLOE FAITH (MS, RD, LD)
Entity type:Individual
Prefix:MISS
First Name:CHLOE
Middle Name:FAITH
Last Name:PAVUK
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3402
Mailing Address - Country:US
Mailing Address - Phone:513-872-9589
Mailing Address - Fax:
Practice Address - Street 1:118 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3402
Practice Address - Country:US
Practice Address - Phone:513-872-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.10140133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered