Organization
DYNUTRIX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEVERLY P JACKSON Ň.D (PRESIDENT)
(203) 962-2995
Entity
Organization
Contact information
Practice address
19 SILK ST, NORWALK, CT 06850-2916
(203) 962-2995
(877) 363-2230
Mailing address
19 SILK ST, NORWALK, CT 06850-2916
(203) 962-2995
(877) 363-2230
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ND00001 FEDERAL LIC
—
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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