Organization
WILD & ROOTED NUTRITION CO. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANDON LEE LEWIS MS, RD, LN (OWNER, DIETITIAN)
(406) 600-2259
Entity
Organization
Contact information
Practice address
825 GREAT NORTHERN BLVD STE 331, HELENA, MT 59601-3392
(406) 792-2876
Mailing address
1511 E BROADWAY ST, HELENA, MT 59601-5234
(406) 600-2259
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/14/2024
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