| NPI | 1861920720 |
|---|---|
| Doing Business As | FUNCTIONAL WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JAN KIELMANN President 909-810-0858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133N00000X Nutritionist |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 174H00000X Health Educator | |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2019-09-19 |