| NPI | 1285869974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN A GICZEWSKI Owner 912-222-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: GA LD002579) |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2009-05-25 |