Andersons Nutrition
Dietitian, Registered in Mesa, AZ. Organization (NPI-2).
NPI number1316337652
StatusActive
Last updated in NPPESMay 15, 2018
Details
- NPI
- 1316337652
- Entity type
- Organization (NPI-2)
- Legal business name
- Andersons Nutrition
- Organization subpart
- No
- Enumeration date
- Jan 26, 2015
- Last updated
- May 15, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1038050 | AZ | Yes |
Practice location
4904 S Power RdSt 188-106
Mesa, AZ 85212
Phone 602-770-7611
Mailing address
4904 S Power RdSt 188-106
Mesa, AZ 85212-3609
Authorized official
Nicole Anderson- Goodrich
President
6027707611
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