NPI | 1295118214 |
---|---|
Doing Business As | ABUNDANT LIFE |
Entity Type | Organization |
Authorized Contact | IDA PEARL CONNORS Provider 702-254-8721 |
Organization Subpart ? | No |
Primary Taxonomy | 133N00000X Nutritionist |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV 506) |
Enumeration Date | 2015-07-08 |
Last Update Date | 2015-07-08 |