Organization
LIFE STYLES NUTRITION SERVICES
Active
Other names
Nutrition to Go, TracyBooth
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY MARIE BOOTH R.D.N (INDEPENDENT CONTRACTOR & PROPRIETOR)
(616) 929-4026
Entity
Organization
Contact information
Practice address
1550 GIDDINGS AVE SE, GRAND RAPIDS, MI 49507
(616) 560-5696
Mailing address
1550 GIDDINGS AVE SE, GRAND RAPIDS, MI 49507-2223
(616) 929-4026
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
723477
MI
Other
Enumeration date
06/11/2007
Last updated
06/19/2018
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