| NPI | 1346904059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA DENISE MOORE-LIESTER Nutritional Operations Manager 719-684-5754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-11-24 |