Organization
FULL CIRCLE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN WOODLAND RD, CDE (REGISTERED DIETITIAN)
(608) 295-6787
Entity
Organization
Contact information
Practice address
1711 HOLIDAY DR, JANESVILLE, WI 53545-0745
(608) 295-6787
Mailing address
N4688 COUNTY ROAD Q, JEFFERSON, WI 53549-9556
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1396-29
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215297114
NPI TYPE 1
—
Enumeration date
05/29/2013
Last updated
05/29/2013
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