Organization
FITNESS AND NUTRITION 101
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMELITA TIBURCIO BIGELOW DT CDM (PROGRAM DIRECTOR)
(336) 222-8616
Entity
Organization
Contact information
Practice address
2253 S CHURCH ST, BURLINGTON, NC 27215-5329
(336) 222-8615
Mailing address
2253 S CHURCH ST, BURLINGTON, NC 27215-5329
(336) 222-8615
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
212708
CA
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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