| NPI | 1003011602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ELIZABETH MCCALLISTER Dietitian 623-399-6825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AZ 875272) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-03-02 |