Organization
LIFESTYLE DIETITIAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JERLYN JONES RD LD (OWNER)
(678) 568-1426
Entity
Organization
Contact information
Practice address
375 RALPH MCGILL BLVD NE APT 1505, ATLANTA, GA 30312-1249
(678) 568-1426
Mailing address
PO BOX 55505, ATLANTA, GA 30308-5505
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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