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Contact Information

IGNITE PERFORMANCE NUTRITION, LLC
71 N JACKSON ST
FORSYTH, GA31029-2168
 Phone: 580-279-0109
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Obesity and Weight Management

133VN1201X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Pediatric

133VN1004X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Sports Dietetics

133VN1501X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for IGNITE PERFORMANCE NUTRITION LLC · (Female)

NPI # 1669227005
Status Active
Credentials
Entity Individual
Enumeration date 04/19/2024
Last updated 04/26/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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