| NPI | 1386016285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY COBLER Owner 979-236-2301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND7562) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT84078) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2018-03-17 |