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Organization
MIDWEST PERFORMANCE NUTRITION LLC
Active
Organization
MIDWEST PERFORMANCE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIGAIL OLCOTT (REGISTERED DIETITIAN)
(309) 397-6406
Entity
Organization
Contact information
Practice address
8060 LEXINGTON PL APT 10, PLEASANT PRAIRIE, WI 53158-2511
(309) 397-6406
Mailing address
8060 LEXINGTON PL APT 10, PLEASANT PRAIRIE, WI 53158-2511
Taxonomy
Speciality
Code
Description
License number
State
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
—
NULL
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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