Healthcare Provider Details
I. General information
NPI: 1750271532
Provider Name (Legal Business Name): RIVER VALLEY DIETETICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/03/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1311 FORT ST STE H
BARLING AR
72923-2045
US
IV. Provider business mailing address
PO BOX 23027
BARLING AR
72923-0027
US
V. Phone/Fax
- Phone: 479-434-8792
- Fax: 479-358-1459
- Phone: 479-434-8792
- Fax: 479-358-1459
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALYSSA
HUBER
Title or Position: OWNER, DIETITIAN
Credential: RD
Phone: 479-434-8792