Envision Nutrition Inc.

NPI #1093036253 in Tyrone, Georgia

Provider Information

NPI Number
1093036253
Entity Type
Organization
Organization Name
Envision Nutrition Inc.
Primary Specialty
Dietitian, Registered
Enumeration Date
Jun 22, 2010
Last Updated
Jun 22, 2010

Practice Location

Address
1922 HIGHWAY 74 N
Address 2
SUITE D
City
Tyrone
State
Georgia
ZIP Code
30290-1660
Phone
(404) 797-0528

Authorized Official

Name
MRS. DONNA P DECAILLE, RD
Title
EXECUTIVE DIRECTOR
Phone
(404) 797-0528

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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