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Organization
SURGICALRX NUTRITION THERAPY PLLC
Active
Organization
SURGICALRX NUTRITION THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYLAN BOURELLE (OPERATOR)
(602) 429-9127
Entity
Organization
Contact information
Practice address
4539 N 22ND ST # 7301, PHOENIX, AZ 85016-4639
(602) 429-9127
Mailing address
1311 VINE ST, CINCINNATI, OH 45202-7118
(602) 429-9127
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/20/2026
Last updated
09/08/2026
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