| NPI | 1518772458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE BANTA Owner 801-755-8056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-10 |