Organization
NUTRIFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE HUFF (REGISTERED DIETITIAN/CO-OWNER)
(314) 609-6835
Entity
Organization
Contact information
Practice address
10407 CLAYTON RD, FRONTENAC, MO 63131-2909
(314) 432-6103
(314) 692-0448
Mailing address
10407 CLAYTON RD, FRONTENAC, MO 63131-2909
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
Update your record
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