Provider Demographics
NPI:1659830750
Name:LETS GET REAL RD LLC
Entity type:Organization
Organization Name:LETS GET REAL RD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-795-8009
Mailing Address - Street 1:1939 FAIRMOUNT AVE UNIT 56202
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2047
Mailing Address - Country:US
Mailing Address - Phone:832-795-8009
Mailing Address - Fax:
Practice Address - Street 1:824 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1403
Practice Address - Country:US
Practice Address - Phone:832-795-8009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty