NPI | 1083089197 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA WALISZEWSKI Registered Dietitian 804-815-4269 |
Organization Subpart ? | Yes |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CO 961152) |
Enumeration Date | 2015-12-01 |
Last Update Date | 2015-12-01 |