Organization
J&M NUTRITIONAL CONSULTING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY L. SULLIVAN R.D, LDN (PRESIDENT/CEO)
(706) 267-7479
Entity
Organization
Contact information
Practice address
4053 JIMMIE DYESS PKWY STE B, AUGUSTA, GA 30909-9472
(706) 267-7479
Mailing address
3522 HILLTOP DR, AUGUSTA, GA 30906-5732
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
LD000433
GA
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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