Organization
NUTRITION FUNDAMENTALS LLC
Active
Organization
NUTRITION FUNDAMENTALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELSIE LEWIS RD, LD, CPT, NFC (OWNER)
(208) 739-5781
Entity
Organization
Contact information
Practice address
204 N JACKSON AVE, JUSTIN, TX 76247-9582
(208) 739-5781
Mailing address
1200 E LAMAR BLVD APT 142, ARLINGTON, TX 76011-4222
(208) 739-5781
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86052742
TX
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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