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Organization
LIFECYCLE NUTRITION SERVICES LLC
Active
Organization
LIFECYCLE NUTRITION SERVICES LLC
Active
Other names
Lifecycle Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN LEMACKS PHD, RD (OWNER)
(850) 556-4377
Entity
Organization
Contact information
Practice address
105 VIRGINIA DR, HATTIESBURG, MS 39401-5831
(850) 556-4377
Mailing address
105 VIRGINIA DR, HATTIESBURG, MS 39401-5831
(850) 556-4377
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1640
MS
Other
Enumeration date
02/10/2018
Last updated
02/10/2018
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