Organization
FOUR PILLARS NUTRITION AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA POULSEN RDN, LD (REGISTERED DIETITIAN AND OWNER)
(208) 649-4171
Entity
Organization
Contact information
Practice address
147 STANFORD AVE, POCATELLO, ID 83201-3425
(208) 649-4171
(208) 646-4394
Mailing address
147 STANFORD AVE, POCATELLO, ID 83201-3425
(208) 424-0179
(208) 646-4394
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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