| NPI | 1407638323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANDREW KELLENBERGER Owner 903-467-9921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |