| NPI | 1275832149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEENA JOY MYLES Operations Manager/Co Owner 228-872-1749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL 234140) |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education (Licence: FL 241367) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |