Organization
MEDICAL NUTRITION THERAPY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON LESLEY WERNER RD (REGISTERED DIETITIAN)
(860) 677-4429
Entity
Organization
Contact information
Practice address
6 RAYMOND RD, AVON, CT 06001-3629
(860) 677-4429
(860) 677-4429
Mailing address
6 RAYMOND RD, AVON, CT 06001-3629
(860) 677-4429
(860) 677-4429
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0003927994
CT
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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