| NPI | 1669899118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BLAKE Certified Nutrition Consultant 760-705-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335G00000X Medical Foods Supplier (Licence: CA co869296) |
| Enumeration Date | 2014-03-22 |
| Last Update Date | 2014-03-22 |