Organization
WHOLESOME NUTRITION, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY MCKINNEY RD, LDN, CDE (REGISTERED DIETITIAN)
(717) 576-6305
Entity
Organization
Contact information
Practice address
400 HORSHAM RD, HORSHAM, PA 19044-2140
(215) 675-4535
Mailing address
305 GREENHILL RD, WILLOW GROVE, PA 19090-2812
(717) 576-6305
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
DN003959
PA
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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