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 |