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Organization
PURE BALANCE CANCER SUPPORT
Active
Organization
PURE BALANCE CANCER SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIK IGNJATOVIC (CO-OWNER)
(801) 558-9174
Entity
Organization
Contact information
Practice address
774 E 2100 S, SALT LAKE CITY, UT 84106-1863
(252) 202-7594
Mailing address
774 E 2100 S, PMB 454, SALT LAKE CITY, UT 84106-1863
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1301X
Oncology Nutrition Registered Dietitian
—
—
Other
Enumeration date
06/09/2026
Last updated
07/20/2026
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