Organization
FOOD FOR LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JOYCE NICHOLOS MS, RDN, LD (OWNER, MEMBER)
(678) 386-4809
Entity
Organization
Contact information
Practice address
3980 GALLANT FOX CT, DULUTH, GA 30096-5416
(678) 386-4809
Mailing address
3980 GALLANT FOX CT, DULUTH, GA 30096-5416
(678) 386-4809
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86077822
GA
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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