Organization
BRAGG NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BRAGG MS, RD (OWNER)
(310) 968-2126
Entity
Organization
Contact information
Practice address
4600 N 24TH ST UNIT 209, PHOENIX, AZ 85016-5369
(310) 968-2126
Mailing address
4600 N 24TH ST UNIT 209, PHOENIX, AZ 85016-5369
(310) 968-2126
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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