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Organization

PROACTIVE DIABETES CONSULTING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA NYQUIST R.D. (REGISTERED DIETITIAN)
(740) 473-6694
Entity
Organization

Contact information

Practice address
11355 S PARKER RD UNIT 101, PARKER, CO 80134-7705
(740) 473-6694
Mailing address
20671 WILLOWBEND LN, PARKER, CO 80138-7122

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
14277
CO

Other

Enumeration date
08/13/2010
Last updated
08/13/2010
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