Organization
TRANSFORMING NUTRITION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PAIGE REDDAN RD LN (OWNER)
(406) 579-9182
Entity
Organization
Contact information
Practice address
14 SOUTH WILLSON AVE, BOZEMAN, MT 59715
(406) 579-9182
(406) 551-1208
Mailing address
14 SOUTH WILLSON AVE, BOZEMAN, MT 59715
(406) 579-9182
(406) 551-1208
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M01100
—
MT
Enumeration date
10/15/2018
Last updated
10/15/2018
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