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Organization
PRO LIFESTYLE NUTRITION
Active
Organization
PRO LIFESTYLE NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RACHEL A HUDES M.S., R.D., L.D.N. (OWNER/DIRECTOR)
(215) 264-2574
Entity
Organization
Contact information
Practice address
405 LODGES LN, ELKINS PARK, PA 19027-2506
(215) 264-2574
Mailing address
405 LODGES LN, ELKINS PARK, PA 19027-2506
(215) 264-2574
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004844
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063779791
INDIVIDUAL NPI
PA
Enumeration date
11/12/2012
Last updated
08/13/2015
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