| NPI | 1780838425 |
|---|---|
| Former Legal Business Name | INNOVATIVE NUTRITION, LLC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER FARNHAM Owner 248-310-1842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric | |
| 133VN1005X Dietitian, Registered, Nutrition, Renal | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic | |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2013-11-19 |