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Organization
PHARA INC
Active
Organization
PHARA INC
Active
Other names
Medical Nutrition Therapy Works
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHARA JOURDAN TAYLOR MS, RD, LDN (CEO)
(617) 461-8503
Entity
Organization
Contact information
Practice address
135 NW MAGNOLIA LAKES BLVD, PORT ST LUCIE, FL 34986-3568
(617) 461-8503
(617) 249-1769
Mailing address
135 NW MAGNOLIA LAKES BLVD, PORT ST LUCIE, FL 34986-3568
(617) 461-8503
(617) 249-1769
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 5606
FL
Other
Enumeration date
01/10/2010
Last updated
02/12/2010
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