| NPI | 1255809836 |
|---|---|
| Doing Business As | NORTHWESTERN LIFESTYLE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MARY E PIGEON Credentialing Specialist 802-524-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 136A00000X Dietetic Technician, Registered | |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2018-11-13 |