Organization
SOUTHWEST NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEMBERLY JOYCE RD, LD (OWNER)
(505) 268-9172
Entity
Organization
Contact information
Practice address
4805 SPRING VALE RD NW, ALBUQUERQUE, NM 87114-4523
(505) 268-9172
Mailing address
4805 SPRING VALE RD NW, ALBUQUERQUE, NM 87114-4523
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
515
NM
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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