| NPI | 1730206954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS G NELSON Secretary 631-722-2246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 4812) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x0109951) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2025-09-11 |