Organization
65 CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA KRISTOF WATTERSON R.D. (REGISTERED DIETITIAN)
(615) 438-4250
Entity
Organization
Contact information
Practice address
218 WINDMERE DR, BOWLING GREEN, KY 42103-8764
(615) 438-4250
Mailing address
218 WINDMERE DR, BOWLING GREEN, KY 42103-8764
(615) 438-4250
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
125985
KY
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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