Organization
HARRIS NUTRITION THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA DUNN HARRIS RD, LD, CDE (OWNER/MANAGER)
(502) 314-0408
Entity
Organization
Contact information
Practice address
3612 BREELAND AVE, LOUISVILLE, KY 40241-2604
(502) 314-0408
Mailing address
3612 BREELAND AVE, LOUISVILLE, KY 40241-2604
(502) 314-0408
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
KY-0195
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY-0195
KY LICENSED REGISTERED DIETITIAN
KY
Enumeration date
08/10/2010
Last updated
08/10/2010
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