| NPI | 1902661440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOURTNEY SIMMANG Owner 214-676-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 175F00000X Naturopath | |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2024-02-14 |