| NPI | 1790530145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA HOLLENBACH Founder & CEO 267-908-4825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-08-16 |