| NPI | 1942410725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL D. BLACKWELL Owner 919-367-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: NC L001396) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 32989) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |