| NPI | 1083925176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORETTE MARIE NYSEWANDER President 904-859-1425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |