| NPI | 1558920637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE BRADLEY MCDONALD Owner 602-770-8924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |