| NPI | 1659153427 |
|---|---|
| Former Legal Business Name | ELITE FIT FOR LIFE |
| Entity Type | Organization |
| Authorized Contact | CLARISSA KAY GANNON CEO 505-377-0059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133N00000X Nutritionist |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |