Organization
BOSTON FUNCTIONAL NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYLA WITHEE RD, LDN (OWNER)
(617) 650-7572
Entity
Organization
Contact information
Practice address
97 LOWELL RD, MILLBROOK TARRY, CONCORD, MA 01742-1733
(617) 650-7572
(888) 835-5844
Mailing address
68 VIRGINIA FARME LN, CARLISLE, MA 01741-1302
(617) 650-7572
(888) 835-5844
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2715
MA
Other
Enumeration date
01/26/2015
Last updated
07/14/2016
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