| NPI | 1467192807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH A ROBERTS Owner/ Lead Dietitian 618-206-8302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |