| NPI | 1295543650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA ELIZABETH COULON CEO 346-413-1887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2025-01-27 |