| NPI | 1851785380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH M MADISON CEO 855-958-9958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 00800548) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2019-10-16 |