Omni Nutrition LLC
NPI #1104363605 in New Smyrna Beach, Florida
Provider Information
- NPI Number
- 1104363605
- Entity Type
- Organization
- Organization Name
- Omni Nutrition LLC
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Jan 23, 2017
- Last Updated
- Aug 11, 2025
Practice Location
- Address
- 404 UNITED DRIVE
- City
- New Smyrna Beach
- State
- Florida
- ZIP Code
- 32168
- Phone
- (386) 968-2170
Authorized Official
- Name
- LARA L CLEVENGER, RD
- Title
- OWNER
- Phone
- (686) 968-2170
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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