Organization
NEELY DEVINE NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORNELE DEVINE RD (OWNER)
(423) 244-8534
Entity
Organization
Contact information
Practice address
300 DURAND DR APT 22, LOOKOUT MOUNTAIN, GA 30750-2707
(423) 244-8534
Mailing address
300 DURAND DR APT 22, LOOKOUT MOUNTAIN, GA 30750-2707
(423) 244-8534
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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