| NPI | 1992150296 |
|---|---|
| Doing Business As | EB-WELLNESS |
| Entity Type | Organization |
| Authorized Contact | ELAINE ANN BEVILLE Authorized Member 904-513-8892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND 5679) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: FL ND 5679) |
| 133NN1002X Nutritionist, Nutrition, Education (Licence: FL ND 5679) | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: FL ND 5679) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |