Organization
SOUTHERN NUTRITION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYSKIE BOLTON RDN (DIRECTOR)
(601) 691-4857
Entity
Organization
Contact information
Practice address
406 BRIARWOOD DR STE 402, JACKSON, MS 39206-3063
(601) 691-4857
Mailing address
406 BRIARWOOD DR STE 402, JACKSON, MS 39206-3063
(601) 691-4857
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/04/2026
Last updated
02/04/2026
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