Organization
SIMPLY DIETETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JORDAN PAIGE MCCOY MS RD LD (OWNER REGISTERED DIETITIAN)
(208) 866-2568
Entity
Organization
Contact information
Practice address
172 N MAIN ST, SUITE 1A, SHERIDAN, WY 82801-3921
(208) 866-2568
Mailing address
PO BOX 542, DAYTON, WY 82836-0542
(208) 866-2568
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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