Organization
KNM DIETETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA MANWILL RD, CD (CO-OWNER, DIETITIAN)
(385) 329-8459
Entity
Organization
Contact information
Practice address
1661 N 800 E, LEHI, UT 84043-3369
(385) 329-8459
Mailing address
1661 N 800 E, LEHI, UT 84043-3369
(385) 329-8459
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
174H00000X
Health Educator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86011527
COMMISSION ON DIETETIC REGISTRATION
—
01
—
9083994-4901
STATE OF UTAH DEPARTMENT OF COMMERCE
UT
Enumeration date
07/27/2018
Last updated
09/02/2020
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