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Organization
URBAN NUTRITION, LLC
Active
Organization
URBAN NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA JULSTEDT COFFEE RD, LD (REGISTERED DIETITIAN)
(817) 366-4643
Entity
Organization
Contact information
Practice address
1209 TIMBER CT, SOUTHLAKE, TX 76092-9225
(817) 366-4643
Mailing address
1209 TIMBER CT, SOUTHLAKE, TX 76092-9225
(817) 366-4643
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT81448
TX
Other
Enumeration date
04/03/2011
Last updated
04/03/2011
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