Organization
TEMPLE NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALESE PUGH (OWNER/DIETITIAN)
(919) 491-9028
Entity
Organization
Contact information
Practice address
4772 FRONTAGE RD, FOREST PARK, GA 30297-1606
(919) 491-9028
Mailing address
7441 MISTYDAWN DR, FAIRBURN, GA 30213-4331
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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