Organization
ANDERSONS NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ANDERSON- GOODRICH MS, RD (PRESIDENT)
(602) 770-7611
Entity
Organization
Contact information
Practice address
4904 S POWER RD, ST 188-106, MESA, AZ 85212
(602) 770-7611
Mailing address
4904 S POWER RD, ST 188-106, MESA, AZ 85212-3609
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1038050
AZ
Other
Enumeration date
01/26/2015
Last updated
05/15/2018
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