Organization
NUTRITION THERAPY LLC
Active
Other names
Nutrition Therapy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIPALI PANCHAL RD, LD (DIETITIAN)
(404) 783-6505
Entity
Organization
Contact information
Practice address
2510 WOOD FERN LN, CUMMING, GA 30041-3439
(404) 783-6505
Mailing address
2510 WOOD FERN LN, CUMMING, GA 30041-3439
(404) 783-6505
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902493679
—
GA
Enumeration date
01/25/2022
Last updated
01/25/2022
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