Organization
DONNAFIT4LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LADONNA GLADNEY NDTR, CPT (OWNER- AND PROVIDER)
(866) 252-2989
Entity
Organization
Contact information
Practice address
3332 N 78TH ST, MILWAUKEE, WI 53222-3920
(414) 866-2522
Mailing address
3332 N 78TH ST, MILWAUKEE, WI 53222-3920
(414) 866-2522
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912673674
—
WI
Enumeration date
01/12/2022
Last updated
01/13/2022
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