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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