Organization
123 NUTRITION, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G STONER II RD, LDN (OWNER/REGISTERED DIETITIAN)
(704) 691-5862
Entity
Organization
Contact information
Practice address
2715 GUSTY LN, MONROE, NC 28110-8001
(704) 691-5862
Mailing address
2715 GUSTY LN, MONROE, NC 28110-8001
(704) 691-5862
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005319
NC
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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