OrganizationActive
Optimal Nutrition LLC
NPI 1073086203 · Health Service Clinic/Center · Glastonbury, CT
Provider details
- NPI number
- 1073086203
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Lisa Shettle, Owner(860) 916-2486
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
65 Kelsey Ln
Glastonbury, CT 06033-5040
Phone: (860) 916-2486
Approximate (ZIP-level) locationGet directions
Mailing address
65 Kelsey Ln
Glastonbury, CT 06033-5040
Registry dates
- Enumerated
- 2019-01-10
- Last updated
- 2019-01-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.