Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lively Nutrition LLC

Organization Registered Dietitian · NPI 1073031894

Lively Nutrition LLC is a Registered Dietitian in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2017.

Licensed in
PA
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

903 N Randolph St
Philadelphia, PA 19123-1407
Phone: (310) 867-9700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence DN006064 (PA)

Record details

NPI number1073031894
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Liv Lee — Owner · (310) 867-9700
NPI enumeratedAugust 31, 2017
Last updated in NPPESSeptember 27, 2021
Certification dateSeptember 27, 2021
Mailing address903 N Randolph St, Philadelphia, PA 19123-1407

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