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General NPI Number Information
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NPI Number | 1073425161
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Entity Type | Organization
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Legal Business Name | FUEL LIFE, LLC
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 29 SUNRISE RD
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City | CODY
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State | WY
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Zip | 82414-9698
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Country | US
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Telephone | 832-408-0225
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Fax |
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Provider Business Mailing Address
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Address Line | 29 SUNRISE RD
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City | CODY
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State | WY
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Zip | 82414-9698
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN, OWNER
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Name | MRS. LAURA MICHELLE BROOKS
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Credential | RDN, LD
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Telephone | 307-250-0939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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