| NPI | 1114643046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE MICHELLE EVANS Owner 888-862-0803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133N00000X Nutritionist |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2024-11-15 |