| NPI | 1023637642 |
|---|---|
| Doing Business As | KSP FITNESS |
| Entity Type | Organization |
| Authorized Contact | KYLE SHANNON Managing Member/Owner 484-894-2631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |