| NPI | 1043070527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIE GREEN Owner 360-990-6072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |