Organization
FUEL WITH PURPOSE
Active
Organization
FUEL WITH PURPOSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE WANSTREET RD, CSSD (SPORTS DIETITIAN)
(405) 985-1417
Entity
Organization
Contact information
Practice address
5928 CONKRIGHT LN, WEST LAFAYETTE, IN 47906-8548
(405) 985-1417
Mailing address
5928 CONKRIGHT LN, WEST LAFAYETTE, IN 47906-8548
(405) 985-1417
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
12/30/2024
Last updated
12/30/2024
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