Organization
MEKENZIE RDN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEKENZIE SMITH GUSTAFSON RDN, LDN (OWNER, DIETITIAN)
(617) 519-0747
Entity
Organization
Contact information
Practice address
40 THOMAS PARK, BOSTON, MA 02127-2947
(617) 519-0747
Mailing address
40 THOMAS PARK UNIT 2, BOSTON, MA 02127-2947
(617) 519-0747
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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