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PROFESSIONAL NUTRITION SERVICES LLC

Dietary & Nutritional Service Providers Nutritionist Nutrition, Education

Provider NPI: 1316477813

Organization Information:
Organization Name:  PROFESSIONAL NUTRITION SERVICES LLC
Organization is not Subpart
Authorized Official:  LATOSHA WILDER YOUNG  OWNER/MANAGER  662-836-4450

Practice Location:
301 LEE ST  BELZONI, MS 39038-3705 US
Tel: (66-2) -836-4450  Fax: --

Business Mailing Address:
301 LEE ST  BELZONI, MS 39038-3705 US
Tel: 662-836-4450  Fax: --

NPI Information:
NPI: 1316477813
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N133NN1002XDietary & Nutritional Service Providers
Nutritionist
Nutrition, Education
MSD1613
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
MSD1613

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 133V00000X

Type:

Classification:



Definition:



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