Provider Demographics
NPI:1053155168
Name:HEALTHY GUT, LLC
Entity type:Organization
Organization Name:HEALTHY GUT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:888-612-5997
Mailing Address - Street 1:3980 BROADWAY ST # 103-166
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1133
Mailing Address - Country:US
Mailing Address - Phone:888-612-5997
Mailing Address - Fax:
Practice Address - Street 1:3924 DIVOT CT
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-8302
Practice Address - Country:US
Practice Address - Phone:888-612-5997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty