Organization
CHARLOTTE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BLACK SMITH RD (AUTHORIZED OFFICIAL, MEMBER)
(980) 224-3514
Entity
Organization
Contact information
Practice address
5821 FAIRVIEW ROAD, SUITE 216, CHARLOTTE, NC 28209
(980) 224-3514
(704) 343-6549
Mailing address
5821 FAIRVIEW ROAD, SUITE 216, CHARLOTTE, NC 28209
(980) 224-3514
(704) 343-6549
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/11/2018
Last updated
02/19/2019
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