Boundless Nutrition LLC

NPI #1033828694 in Fairfax, Virginia

Provider Information

NPI Number: 1033828694
Entity Type: Organization
Organization Name: Boundless Nutrition LLC
Primary Specialty: Clinic/Center
Enumeration Date: Nov 22, 2022
Last Updated: Nov 22, 2022

Practice Location

Address: 13112 MOSS RANCH LN
City: Fairfax
State: Virginia
ZIP Code: 22033-3524
Phone: (703) 705-2720

Authorized Official

Name: MIRIAM EACKLOFF, RD
Title: OWNER
Phone: (703) 705-2720

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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