Organization
TOTAL BALANCE DIETITIAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FULKS (OWNER, COO)
(701) 306-5060
Entity
Organization
Contact information
Practice address
1461 BROADWAY N, FARGO, ND 58102-2622
(701) 293-6037
Mailing address
1461 BROADWAY N, FARGO, ND 58102-2622
(701) 293-6037
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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