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Organization
PCOS NUTRITION & LACTATION SERVICES
Active
Organization
PCOS NUTRITION & LACTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEILA MARINA KERNS RD, IBCLC (BUSINESS OWNER)
(707) 227-6518
Entity
Organization
Contact information
Practice address
2658 PERN PL, SANTA ROSA, CA 95404-5443
(707) 314-3048
Mailing address
2658 PERN PL, SANTA ROSA, CA 95404-5443
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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