Organization
IDENTITY NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA JANE BROCHET MA, RD, LDN, CDCES (OWNER)
(610) 466-5649
Entity
Organization
Contact information
Practice address
1284 STERNER MILL RD, COATESVILLE, PA 19320-7702
(610) 466-5649
Mailing address
1284 STERNER MILL RD, COATESVILLE, PA 19320-7702
(610) 466-5649
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
04/26/2024
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