| NPI | 1275358004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN STODDARD Manager/Owner 904-885-4635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |