Organization Name: | MEDABOLIX, INC. |
NPI Number: | 1780898072 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL STICKLER (PRESIDENT CEO) |
Mailing Address: | 600 Tracy Way Suite 200 Charleston |
State: | WV US |
Postal Code: | 253111262 |
Phone Number: | 3043474313 |
Fax Number: | 3043474316 |
NPI Enumeration Date: | 05/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |