Organization
TAILORED NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GEORGIA FLETCHER BOLEY MS,RD,LD,CSO (REGISTERED DIETITIAN)
(307) 752-8213
Entity
Organization
Contact information
Practice address
37 S MAIN ST, SHERIDAN, WY 82801-4221
(307) 752-8213
(307) 675-1866
Mailing address
37 S MAIN ST, SHERIDAN, WY 82801-4221
(307) 752-8213
(307) 675-1866
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
81
WY
Other
Enumeration date
02/24/2014
Last updated
09/11/2014
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