| NPI | 1639642390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN MANCHA MCLEAN Co Owner 956-645-9716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2019-01-05 |