Organization
WHOLE IMPACT NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA L MARTINE MS, RD, LDN (MEMBER & ORGANIZER)
(910) 409-3996
Entity
Organization
Contact information
Practice address
4205 RIVER BIRCH LOOP, APT 3A, GREENSBORO, NC 27409-8048
(910) 409-3996
Mailing address
4205 RIVER BIRCH LOOP, APT 3A, GREENSBORO, NC 27409-8048
(910) 409-3996
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L003743
NC
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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