| NPI | 1316637812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY BLALOCK Owner 434-234-4591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1004X Dietitian, Registered Nutrition, Pediatric |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |