Provider Demographics
NPI:1548748676
Name:EAT PRACTICAL LLC
Entity type:Organization
Organization Name:EAT PRACTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLLING
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN, CLT
Authorized Official - Phone:913-314-0145
Mailing Address - Street 1:7407 CONNER LN
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-4669
Mailing Address - Country:US
Mailing Address - Phone:913-314-0145
Mailing Address - Fax:
Practice Address - Street 1:7407 CONNER LN
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-4669
Practice Address - Country:US
Practice Address - Phone:913-314-0145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.007078133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty