Organization
NORTHERN NUTRITION GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY JOHNSON RD (OWNER)
(229) 560-8807
Entity
Organization
Contact information
Practice address
2002 N 22ND AVE STE 2, BOZEMAN, MT 59718-3153
(406) 282-1398
(406) 551-1420
Mailing address
PO BOX 73, BOZEMAN, MT 59771
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134654759
—
MT
05
—
1740754472
—
MT
Enumeration date
01/16/2019
Last updated
06/14/2022
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