Organization
BASIC BALANCE NUTRITION, INC.
Active
Organization
BASIC BALANCE NUTRITION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI ELIZABETH BONIN MS, RD, LD (REGISTERED DIETITIAN)
(936) 337-2981
Entity
Organization
Contact information
Practice address
1217 AVENUE M STE 113, HUNTSVILLE, TX 77340
(936) 337-2981
(936) 755-5115
Mailing address
1217 AVENUE M STE 113, HUNTSVILLE, TX 77340-4650
(936) 337-2981
(936) 755-5115
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84230
TX
Other
Enumeration date
11/27/2017
Last updated
08/14/2018
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