Organization
DIET OF A LIFETIME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA C GOLDMON (OWNER)
(870) 540-9114
Entity
Organization
Contact information
Practice address
123 S PINE ST, PINE BLUFF, AR 71601-4222
(870) 540-9114
Mailing address
420 SANDY BAYOU LN, PINE BLUFF, AR 71603-6555
(870) 850-0351
(870) 850-0351
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
About Stedi
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