Organization
SPROUT PEDIATRIC NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLIN WADDLE MS, RDN, LD (OWNER)
(404) 654-3906
Entity
Organization
Contact information
Practice address
4045 ORCHARD RD SE STE 500, SMYRNA, GA 30080-4900
(404) 654-3906
Mailing address
2062 VILLAGE CREST DR NW, ATLANTA, GA 30318-1064
(502) 648-9464
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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