Organization
LIFETIME NUTRITION AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY ANN GLASER RDN (OWNER/ DIETITIAN)
(402) 802-2639
Entity
Organization
Contact information
Practice address
5592 DAVIS BLVD, N RICHLAND HILLS, TX 76180-5202
(817) 718-9412
Mailing address
PO BOX 820472, N RICHLAND HILLS, TX 76182-0472
(817) 718-9412
(682) 200-3258
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
08/22/2019
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