| NPI | 1831969047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA MARINO REILLY Registered Dietitian 424-501-5265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |