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 provides Registered Dietitian services 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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