| NPI | 1174376289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN HARRIS Owner 336-624-3191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-09 |