Organization
TOP FUNCTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE WOODWARD (OWNER AND FOUNDER)
(310) 294-4804
Entity
Organization
Contact information
Practice address
18002 FLYNN DR, UNIT 6208, CANYON COUNTRY, CA 91387-8246
(310) 294-4804
Mailing address
18002 FLYNN DR, UNIT 6208, CANYON COUNTRY, CA 91387-8246
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
20091588239
NV
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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