Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nutrition, Education |
133NN1002X |
| NPI # | 1619219631 |
| LBN Legal business name | EASTSIDE NUTRITION LLC |
| Authorized official | STEPHANIE JONES - (OWNER/REGISTERRED DIETITIAN) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/18/2013 |
| Last updated | 03/18/2013 - About 13 years ago |
| Identifiers | n/a |
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