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Organization
AM NUTRITION SERVICES
Active
Organization
AM NUTRITION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY ELIZABETH MCCALLISTER RD (DIETITIAN)
(623) 399-6825
Entity
Organization
Contact information
Practice address
18001 N 79TH AVE STE A12, GLENDALE, AZ 85308
(623) 399-6825
(623) 505-3474
Mailing address
18001 N 79TH AVE STE A12, GLENDALE, AZ 85308-8398
(623) 399-6825
(623) 505-3474
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
875272
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
547661
—
AZ
01
—
V62714
PTAN
NV
01
—
Z115443
PTAN
AZ
Enumeration date
06/15/2007
Last updated
08/08/2024
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