| NPI | 1811357668 |
|---|---|
| Doing Business As | NORTHWESTERN LIFESTYLE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MARY PIGEON Credentialing Specialist 802-524-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-11 |