Diet of a Lifetime, LLC
NPI #1811553555 in Pine Bluff, Arkansas
Provider Information
- NPI Number
- 1811553555
- Entity Type
- Organization
- Organization Name
- Diet of a Lifetime, LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- May 17, 2019
- Last Updated
- May 17, 2019
Practice Location
- Address
- 123 S PINE ST
- City
- Pine Bluff
- State
- Arkansas
- ZIP Code
- 71601-4222
- Phone
- (870) 540-9114
Authorized Official
- Name
- DEBRA C GOLDMON
- Title
- OWNER
- Phone
- (870) 540-9114
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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