| NPI | 1649549122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA M BRISTOW Registered Dititian 802-777-9691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: VT 0740076077) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |