| NPI | 1831595560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI D BOLIN Registered Dietitian 316-312-6388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KS 1966) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2014-12-30 |