# KB MEDICAL NUTRITION THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649749979
- **Authorized official:** KATHRYN LEIGH BALKUNAS (OWNER)
- **Authorized official phone:** (860) 484-9808

## Contact information

- **Practice address:** 500 BURLINGTON RD, HARWINTON, CT 06791-1506
- **Practice address phone:** (860) 485-0405
- **Mailing address:** 197 JOHNNYCAKE MOUNTAIN RD, BURLINGTON, CT 06013-2011
- **Mailing address phone:** (860) 484-9808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | — | NULL | Yes |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2018
- **Last updated:** 11/15/2018