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Organization
LG NUTRITION LLC
Active
Organization
LG NUTRITION LLC
Active
Other names
Summerfield Custom Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA RENEE GREENHOW BRANSFIELD (OWNER)
(910) 663-5166
Entity
Organization
Contact information
Practice address
1209 MARKET ST, SUITE J, WILMINGTON, NC 28401-4345
(910) 663-5166
Mailing address
8801 FAST PARK DR STE 213, RALEIGH, NC 27617-4853
(919) 442-8398
(888) 856-3502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004173
NC
Other
Enumeration date
09/09/2013
Last updated
04/27/2021
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