Organization
PRUDENT-LIFESTYLES NUTRITION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONJA MARIA STALLINGS R.D. (DIETITIAN)
(248) 866-4967
Entity
Organization
Contact information
Practice address
17570 SAN ROSA BLVD, LATHRUP VILLAGE, MI 48076-2715
(248) 866-4967
(248) 559-5081
Mailing address
17570 SAN ROSA BLVD, LATHRUP VILLAGE, MI 48076-2715
(248) 866-4967
(248) 559-5081
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
07/18/2007
Last updated
08/06/2007
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