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Organization
HOLISTIC NUTRITION BY LISA
Active
Organization
HOLISTIC NUTRITION BY LISA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BLAKE CNC (CERTIFIED NUTRITION CONSULTANT)
(760) 705-5444
Entity
Organization
Contact information
Practice address
2785 ROOSEVELT ST, SUITE B, CARLSBAD, CA 92008-1779
(760) 705-5444
Mailing address
3446 RAVINE DR, CARLSBAD, CA 92010-5557
(760) 705-5444
Taxonomy
Speciality
Code
Description
License number
State
335G00000X
Medical Foods Supplier
Primary
CO869296
CA
Other
Enumeration date
03/22/2014
Last updated
03/22/2014
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