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Organization

RIDGELINE DIETETICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA NIELSEN RD (OWNER/REGISTERED DIETITIAN)
(612) 723-0735
Entity
Organization

Contact information

Practice address
3718 RED CANON PL, COLORADO SPRINGS, CO 80904-2323
(612) 723-0735
Mailing address
3718 RED CANON PL, COLORADO SPRINGS, CO 80904-2323
(612) 723-0735

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
07/19/2024
Last updated
07/19/2024
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