| NPI | 1639573447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY MADZIN Owner 423-598-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TN 844622) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: 844622) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |