Organization · NPI-2

Bright Sky Nutrition, LLC

Clinic/Center · Springfield, MO

NPI number1124477104
StatusActive
Last updated in NPPESJul 6, 2016

Details

NPI
1124477104
Entity type
Organization (NPI-2)
Legal business name
Bright Sky Nutrition, LLC
Organization subpart
No
Enumeration date
Jun 9, 2016
Last updated
Jul 6, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center2004029834MOYes

Other names

  • Sunshine Weight Loss Club, LLC (Former Legal Business Name)

Practice location

3543 S Lone Pine Ave
Springfield, MO 65804-4854

Phone 417-343-8222 · Fax 866-542-3416

Mailing address

3243 W Katella Ct
Springfield, MO 65807-8713

Phone 417-343-8222 · Fax 866-542-3416

Authorized official

Ladonna Marie Webb
Owner/Dietitian
4173438222

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