| NPI | 1790157840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSON DENISE FLAKER Registered Dietitian 862-377-5445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |