Prairie View Creations LLC
NPI #1063979961 in Prescott Valley, Arizona
Provider Information
- NPI Number
- 1063979961
- Entity Type
- Organization
- Organization Name
- Prairie View Creations LLC
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Feb 27, 2019
- Last Updated
- Nov 3, 2020
Practice Location
- Address
- 8508 N PRAIRIE VW
- City
- Prescott Valley
- State
- Arizona
- ZIP Code
- 86315-9089
- Phone
- (928) 772-8652
Authorized Official
- Name
- CHAD HETHERWICK, MS, RD
- Title
- REGISTERED DIETITIAN NUTRITIONIST
- Phone
- (928) 772-8652
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered - Nutrition, Pediatric — Nutrition, Pediatric |
| Dietitian, Registered - Nutrition, Renal — Nutrition, Renal |
| Dietitian, Registered - Nutrition, Metabolic — Nutrition, Metabolic |
| Dietitian, Registered |
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