Organization
TETON DIETETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXY V NELSON RD (OWNER)
(208) 270-4306
Entity
Organization
Contact information
Practice address
680 E 5500 S, VICTOR, ID 83455-4613
(208) 270-4306
Mailing address
680 E 5500 S, VICTOR, ID 83455-4613
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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