Organization
AUTUMN ENLOE NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN NICOLE ENLOE MS, RD, LD, CLT (REGISTERED DIETITIAN)
(651) 504-3118
Entity
Organization
Contact information
Practice address
14436 57TH ST N, OAK PARK HEIGHTS, MN 55082
(651) 504-3118
Mailing address
14436 57TH ST N., OAK PARK HEIGHTS, MN 55082
(651) 504-3118
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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