| NPI | 1023355245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HANCOCK Dietitian 731-541-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2013-01-08 |