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Organization

PWM NUTRITION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PARKER WALLACE MCKINNON RD (OWNER, DIETITIAN)
(980) 374-3556
Entity
Organization

Contact information

Practice address
4030 WAKE FOREST RD STE 349, RALEIGH, NC 27609-0010
(980) 374-3556
Mailing address
4030 WAKE FOREST RD STE 349, RALEIGH, NC 27609-0010

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
03/09/2026
Last updated
03/09/2026
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