Red River Medical Nutrition LLC
Dietitian, Registered in Oakdale, LA. Organization (NPI-2).
NPI number1013472166
StatusActive
Last updated in NPPESFeb 21, 2019
Details
- NPI
- 1013472166
- Entity type
- Organization (NPI-2)
- Legal business name
- Red River Medical Nutrition LLC
- Organization subpart
- No
- Enumeration date
- Feb 4, 2019
- Last updated
- Feb 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
| 133NN1002X | Nutritionist, Nutrition, Education | – | – | |
| 133VN1004X | Dietitian, Registered, Nutrition, Pediatric | – | – | |
| 133VN1006X | Dietitian, Registered, Nutrition, Metabolic | – | – |
Practice location
1115 E 7th AveOakdale, LA 71463-2301
Phone 318-485-9238
Mailing address
148 Douglas Memorial RdLeesville, LA 71446-5404
Phone 318-485-9238
Authorized official
Alexis D Motley
Manager
3184859238
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