Organization
NUTRITION THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BATES RD (REGISTERED DIETITIAN)
(904) 504-5955
Entity
Organization
Contact information
Practice address
2406 E LLANO ESTACADO BLVD APT G, CLOVIS, NM 88101-3999
(904) 504-5955
Mailing address
2400 E LLANO ESTACADO BLVD APT 2406-G, CLOVIS, NM 88101-3974
(904) 504-5955
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
10/11/2024
Last updated
10/11/2024
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