Organization
ELEMENTARY NUTRITION
Active
Other names
Elementary Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
LISA NORMAN RND, CNSC (OWNER)
(623) 363-4337
Entity
Organization
Contact information
Practice address
609 MINGUS AVE, PRESCOTT, AZ 86301-1030
(623) 363-4337
Mailing address
609 MINGUS AVE, PRESCOTT, AZ 86301-1030
(623) 363-4337
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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