Organization
INNOVATIVE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BROOKE GACEK RDN, LD (OWNER)
(205) 305-2840
Entity
Organization
Contact information
Practice address
100 MEMORIAL HOSPITAL DR STE 3C, MOBILE, AL 36608-1185
(251) 272-9654
(251) 243-4942
Mailing address
2889 SOLLIE RD APT 303, MOBILE, AL 36695-5535
(205) 305-2840
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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