Organization
BIRCHWOOD NUTRITION GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY BETH MINOGUE MS, RD, LDN (PRESIDENT/REGISTERED DIETITAN)
(781) 724-9359
Entity
Organization
Contact information
Practice address
77R W MAIN ST # R, HOPKINTON, MA 01748-1688
(781) 724-9359
Mailing address
30 PURDUE DR, MILFORD, MA 01757-1243
(781) 724-9359
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2088
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366628463
INDIVIDUAL NPI
MA
01
—
2088
MASS NUTRITION LICENSURE
MA
01
—
922444
CERTIFIED REGISTERED DIETITIAN
MA
Enumeration date
10/01/2015
Last updated
10/01/2015
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