Renegade Rd LLC

NPI #1467282673 in Georgetown, Texas

Provider Information

NPI Number
1467282673
Entity Type
Organization
Organization Name
Renegade Rd LLC
Primary Specialty
Dietitian, Registered
Enumeration Date
Aug 2, 2024
Last Updated
Aug 2, 2024

Practice Location

Address
909 BALSORA CV
State
Texas
ZIP Code
78628-2637
Phone
(936) 349-6546

Authorized Official

Name
SANTIAGO CAPETILLO GUTIERREZ, MS, RD, LD
Title
REGISTERED DIETITIAN
Phone
(936) 349-6546

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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