Organization
NUTRITION BALANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE E CONSIGLIO RD (REGISTERED DIETITIAN)
(586) 778-4877
Entity
Organization
Contact information
Practice address
22811 GREATER MACK AVE, SUITE 105, SAINT CLAIR SHORES, MI 48080-2021
(586) 778-4877
(586) 778-3004
Mailing address
22811 GREATER MACK AVE, SUITE 105, SAINT CLAIR SHORES, MI 48080-2021
(586) 778-4877
(586) 778-3004
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
00595403
MI
Other
Enumeration date
03/01/2014
Last updated
03/01/2014
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