| NPI | 1972375673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY THOMAS PONDS Owner 803-575-0468 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| 163WD0400X Registered Nurse, Diabetes Educator | |
| 133N00000X Nutritionist | |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric | |
| 133VN1005X Dietitian, Registered, Nutrition, Renal | |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2023-10-25 |