Healthcare Provider Details

I. General information

NPI: 1821939794
Provider Name (Legal Business Name): ALSTROM & CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W RIO SALADO PKWY APT 1017
TEMPE AZ
85281-3739
US

IV. Provider business mailing address

701 W RIO SALADO PKWY APT 1017
TEMPE AZ
85281-3739
US

V. Phone/Fax

Practice location:
  • Phone: 620-491-3249
  • Fax:
Mailing address:
  • Phone: 620-491-3249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. BRETA ALSTROM
Title or Position: DIETITIAN/OWNER
Credential: MS, RDN, LD
Phone: 620-491-3249