| NPI | 1750758561 |
|---|---|
| Former Legal Business Name | A.M. WADE NUTRITION GROUP LLC |
| Entity Type | Organization |
| Authorized Contact | KELLY LAKE Office Admin 412-593-2048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator |
| 174H00000X Health Educator | |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2023-11-27 |