Organization
NUTRITION FOR PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GOEBEL RD, LDN (OWNER)
(360) 441-0349
Entity
Organization
Contact information
Practice address
31 SAINT JAMES AVE, BOSTON, MA 02116-4101
(360) 441-0349
Mailing address
56 PRINCE ST APT 1, BOSTON, MA 02113-1826
(360) 441-0349
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083220586
—
MA
Enumeration date
12/17/2021
Last updated
12/17/2021
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