Organization
NEW LEAF NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSAY KEENEY (RD)
(206) 948-8810
Entity
Organization
Contact information
Practice address
5261 N PORT WASHINGTON RD, GLENDALE, WI 53217-4903
(206) 948-8810
Mailing address
5261 N PORT WASHINGTON RD, GLENDALE, WI 53217-4903
(206) 948-8810
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDD10150450
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500703686
—
OR
Enumeration date
04/13/2017
Last updated
01/22/2018
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