Nutrition Therapy New Mexico LLC

NPI #1710380910 in Los Alamos, New Mexico

Provider Information

NPI Number: 1710380910
Entity Type: Organization
Organization Name: Nutrition Therapy New Mexico LLC
Primary Specialty: Dietitian, Registered
Enumeration Date: Oct 1, 2014
Last Updated: Apr 15, 2015

Practice Location

Address: 2185 44TH ST
Address 2: STE D
City: Los Alamos
State: New Mexico
ZIP Code: 87544-1750
Phone: (505) 412-5983

Authorized Official

Name: MARY PATRICIA WILLMS, RD
Title: CEO/MEDICAL DIRECTOR
Phone: (505) 412-5983

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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