Organization
CULTIVATE NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEIGH HANSEN (REGISTERED DIETITIAN)
(847) 651-1384
Entity
Organization
Contact information
Practice address
316 GATEWOOD LN, GRAYSLAKE, IL 60030-3731
(847) 651-1384
Mailing address
316 GATEWOOD LN, GRAYSLAKE, IL 60030-3731
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/10/2024
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