Organization
SUMMIT NUTRITION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERPETUA DELRINE FERNANDO PHD, RD, CD (REGISTERED DIETITIAN)
(260) 487-9983
Entity
Organization
Contact information
Practice address
3027 MARIPOSA PLACE, FORT WAYNE, IN 46818
(260) 487-9983
(260) 489-5072
Mailing address
3027 MARIPOSA PLACE, FORT WAYNE, IN 46818
(260) 487-9983
(260) 489-5072
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001987A
IN
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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