Organization
CLEAN SLATE NUTRITION
Active
Other names
Peggy Cosgrove, MS, RD, LD
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGYC COSGROVE MS, RD, LD (DIETITIAN/OWNER)
(501) 580-0295
Entity
Organization
Contact information
Practice address
709 N BUCHANAN ST, LITTLE ROCK, AR 72205-3264
(501) 580-0295
Mailing address
709 N BUCHANAN ST, LITTLE ROCK, AR 72205-3264
(501) 580-0295
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1005772
AR
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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