| NPI | 1225785561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA LEIGH BRANZ Owner/Dietitian 618-304-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2022-03-07 |