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Organization

MY SIGNATURE NUTRITION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SARA UPSON M.ED, RD, LD (OWNER)
(903) 312-8906
Entity
Organization

Contact information

Practice address
5620 OLD BULLARD RD, SUITE 125, TYLER, TX 75703-4358
(903) 312-8906
Mailing address
5620 OLD BULLARD RD, SUITE 125, TYLER, TX 75703-4358
(903) 312-8906

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82055
TX

Other

Enumeration date
10/09/2014
Last updated
10/09/2014
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