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Organization
JG NUTREND PROVIDERS PA
Active
Organization
JG NUTREND PROVIDERS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY NAN WHITMEYER (PRACTICE MANAGER)
(346) 246-3424
Entity
Organization
Contact information
Practice address
425 HOLDERRIETH BLVD STE 212, TOMBALL, TX 77375-4552
(346) 246-4171
Mailing address
PO BOX 27095, BELFAST, ME 04915-2022
(346) 246-4171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
Other
Enumeration date
05/13/2020
Last updated
03/31/2021
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