North Idaho Weight Loss, Llc.
NPI #1134768393 in Coeur D Alene, Idaho
Provider Information
- NPI Number
- 1134768393
- Entity Type
- Organization
- Organization Name
- North Idaho Weight Loss, Llc.
- Primary Specialty
- Dietitian, Registered - Nutrition, Obesity and Weight Management
- Enumeration Date
- Jan 5, 2020
- Last Updated
- Jan 5, 2020
Practice Location
- Address
- 118 N 7TH ST STE C12
- City
- Coeur D Alene
- State
- Idaho
- ZIP Code
- 83814-2709
- Phone
- (208) 274-3611
Authorized Official
- Name
- PENNY J BURCIAGA
- Title
- FUNCTIONAL NUTRITIONIST/OWNER
- Phone
- (805) 888-7077
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered - Nutrition, Obesity and Weight Management — Nutrition, Obesity and Weight Management |
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