Organization
NUTRICOACHAZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE ROEHR MS, RDN (CEO)
(623) 258-2608
Entity
Organization
Contact information
Practice address
9075 S PARKSIDE LN E, BUCKEYE, AZ 85326-2448
(623) 258-2608
Mailing address
PO BOX 387, BUCKEYE, AZ 85326-0030
(623) 258-2608
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336797471
NPPES
—
Enumeration date
03/09/2020
Last updated
03/09/2020
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