| NPI | 1063732287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA NYQUIST Registered Dietitian 740-473-6694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 14277) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CO 14277) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2011-01-24 |