| NPI | 1295193084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEILA ALEXANDRA DAVIS Nutrition And Diet Technicina 870-224-5492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 136A00000X Dietetic Technician, Registered (Licence: AR 1057724) |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |