Deep Well Collective

NPI #1669210969 in Afton, Virginia

Provider Information

NPI Number: 1669210969
Entity Type: Organization
Organization Name: Deep Well Collective
Primary Specialty: Nutritionist
Enumeration Date: Jul 19, 2024
Last Updated: Jul 19, 2024

Practice Location

Address: 2071 AFTON MOUNTAIN RD
City: Afton
State: Virginia
ZIP Code: 22920-2308
Phone: (434) 326-8635

Authorized Official

Name: DR. RYAN D HALL, DCN, CNS, LDN
Title: CEO
Phone: (434) 326-8635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist - Nutrition, Education — Nutrition, Education	133NN1002X
Dietitian, Registered	133V00000X
Dietitian, Registered - Nutrition, Metabolic — Nutrition, Metabolic	133VN1006X
Dietitian, Registered - Nutrition, Obesity and Weight Management — Nutrition, Obesity and Weight Management	133VN1201X
Dietitian, Registered - Nutrition, Oncology — Nutrition, Oncology	133VN1301X
Dietitian, Registered - Nutrition, Sports Dietetics — Nutrition, Sports Dietetics	133VN1501X
Nutritionist	133N00000X	Primary

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