| NPI | 1134739485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY E BLOOD Owner 907-328-0844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Enumeration Date | 2020-08-02 |
| Last Update Date | 2021-12-02 |