Organization
FLOURISH. NUTRITION THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER N MAHONEY RD, LD (OWNER/REGISTERED DIETITIAN)
(314) 605-3287
Entity
Organization
Contact information
Practice address
6222 POTOMAC ST, SAINT LOUIS, MO 63139-2011
(314) 605-3287
Mailing address
6222 POTOMAC ST, SAINT LOUIS, MO 63139-2011
(314) 605-3287
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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