Organization
COMPLETE BALANCE WEIGHT LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA LYNN BRAXTON PHARMD (OWNER)
(248) 225-7927
Entity
Organization
Contact information
Practice address
16250 NORTHLAND DR STE 204, SOUTHFIELD, MI 48075-5226
(248) 973-7670
Mailing address
16250 NORTHLAND DR STE 204, SOUTHFIELD, MI 48075-5226
(248) 973-7670
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/19/2020
Last updated
04/14/2020
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