Organization Name: | COASTAL NUTRITION SPECIALISTS, LLC |
NPI Number: | 1548592264 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY A YOUNGBLOOD (OWNER) |
Mailing Address: | 141 Nandina Way Pooler |
State: | GA US |
Postal Code: | 313224076 |
Phone Number: | 9126601215 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2010 |
NPI Last Update Date: | 02/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | LD002323 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |