Organization
LIFECYCLE NUTRITION SERVICES LLC
Active
Other names
Lifecycle Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN LEMACKS PHD, RD (OWNER)
(850) 556-4377
Entity
Organization
Contact information
Practice address
105 VIRGINIA DR, HATTIESBURG, MS 39401-5831
(850) 556-4377
Mailing address
105 VIRGINIA DR, HATTIESBURG, MS 39401-5831
(850) 556-4377
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1640
MS
Other
Enumeration date
02/10/2018
Last updated
02/10/2018
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