| NPI | 1982453700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI GAUTREAX-KLIEBERT Owner 985-335-6442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172M00000X Mechanotherapist |
| Additional Taxonomies | 133VN1501X Dietitian, Registered Nutrition, Sports Dietetics |
| 171400000X | |
| 133NN1002X Nutritionist Nutrition, Education | |
| 174H00000X Health Educator | |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-15 |