| NPI | 1104199116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LYNN BROWN Registered Dietitian 541-905-2567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OR 587) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 888970) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2012-02-22 |