MD Nutrition and Lifestyle, LLC
NPI #1972002301 in Kingstowne, Virginia
Provider Information
- NPI Number
- 1972002301
- Entity Type
- Organization
- Organization Name
- MD Nutrition and Lifestyle, LLC
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Feb 12, 2018
- Last Updated
- Feb 12, 2018
Practice Location
- Address
- 5901 KINGSTOWNE VILLAGE PKWY
- Address 2
- SUITE 300
- City
- Kingstowne
- State
- Virginia
- ZIP Code
- 22315
- Phone
- (860) 796-1930
Authorized Official
- Name
- MISS MARA MICHELE DAVIS, MS, RD, CDN, LPN
- Title
- CLINICAL DIETITAN
- Phone
- (860) 796-1930
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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