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Organization
VITAL NUTRITION DIETITIAN
Active
Organization
VITAL NUTRITION DIETITIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN BREEDON RD (OWNER)
(734) 755-4975
Entity
Organization
Contact information
Practice address
4083 SW 49TH TER, OCALA, FL 34474-9684
(734) 755-4975
(352) 352-9390
Mailing address
4083 SW 49TH TER, OCALA, FL 34474-9684
(734) 755-4975
(352) 352-9390
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/12/2023
Last updated
01/23/2024
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