Organization
GYMBOOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA MARIE BACKES RDN (PROVIDER)
(320) 309-8913
Entity
Organization
Contact information
Practice address
3250 W 66TH ST APT 548, EDINA, MN 55435-5514
(320) 309-8913
Mailing address
3250 W 66TH ST APT 548, EDINA, MN 55435-5514
(320) 309-8913
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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