| NPI | 1235726845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA ELLENBERG Registered Dietitian 704-351-1552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2020-12-29 |