Organization Name: | LIFE STYLES NUTRITION SERVICES |
NPI Number: | 1902009475 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRACY MARIE BOOTH (INDEPENDENT CONTRACTOR & PROPRIETOR) |
Mailing Address: | 1550 Giddings Ave Se Grand Rapids |
State: | MI US |
Postal Code: | 495072223 |
Phone Number: | 6165605696 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2007 |
NPI Last Update Date: | 06/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 723477 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |