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Organization
BAMBOO NUTRITION, LLC
Active
Organization
BAMBOO NUTRITION, LLC
Active
Other names
Bamboo Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ISABELLE BOUCHARD MS, RDN (OWNER)
(573) 343-4017
Entity
Organization
Contact information
Practice address
1905 CHERRY HILL DR STE 300, COLUMBIA, MO 65203-5812
(573) 343-4017
(573) 615-4443
Mailing address
2012 CHERRY HILL DR STE 202B, COLUMBIA, MO 65203-5882
(573) 343-4017
(573) 615-4443
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017032772
MISSOURI DIVISION OF PROFESSIONAL REGISTRATION
MO
01
—
2018035632
MISSOURI DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
06/24/2020
Last updated
01/27/2026
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