Organization
LUNA NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KNOX CNS (OWNER)
(615) 579-2435
Entity
Organization
Contact information
Practice address
10850 LINCOLN TRAIL, STE 16, #248, FAIRVIEW HEIGHTS, IL 62208
(615) 579-2435
Mailing address
10850 LINCOLN TRAIL, STE 16, #248, FAIRVIEW HEIGHTS, IL 62208
(615) 579-2435
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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