Compass Nutrition, Llc

NPI 1104199116 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1104199116
Enumeration Date 02/22/2012
Last Updated 02/22/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name JACKIE LYNN JACKIE
Position REGISTERED DIETITIAN
Phone (541) 905-2567
Fax (541) 393-2981
Practice Location
1290 FENWICK AVENUE
COOS BAY OR, 97420, US
Phone (541) 905-2567
Fax (541) 393-2981
Business Location
1290 FENWICK AVENUE
COOS BAY OR, 97420, US
Phone (541) 905-2567
Fax (541) 393-2981
Toxanomy
Taxonomy Code 133V00000X
License State
License Number 888970
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According to our database, Compass Nutrition, Llc NPI is 1104199116, taxonomy code is 133V00000X and license number is 888970, license state is located at . Compass Nutrition, Llc physically located at 1290 Fenwick Avenue, Coos Bay OR, 97420. NPI Number 1033115704 has the healthcare provider type.

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1104199116 NPI number is provided on an as is basis without warranty of any kind. 1104199116 is maintained by the National Plan & Provider Enumeration System. The contents of Compass Nutrition, Llc are for informational purposes only.