| NPI | 1912461799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEAH MICHELLE PHILLIPS Billing And Credentialing Manager 901-205-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2026-03-17 |