Organization
MIND BODY SOUL REVIVAL LLC
Active
Organization
MIND BODY SOUL REVIVAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA O'CONNOR MS, RD, CEDS (REGISTERED DIETITIAN)
(774) 270-7018
Entity
Organization
Contact information
Practice address
845 VANCE ST, LAKEWOOD, CO 80214-4828
(774) 270-7018
Mailing address
845 VANCE ST, LAKEWOOD, CO 80214-4828
(774) 270-7018
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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