| NPI | 1942697198 |
|---|---|
| Other Name | LIVELY GREENS |
| Entity Type | Organization |
| Authorized Contact | JORDAN LYNN BOUCHER Registered Dietitian 713-689-9673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI 60543717) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |