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General NPI Number Information
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NPI Number | 1295361756
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Entity Type | Organization
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Legal Business Name | TURNING TIDES INC
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 4803 MANGROVE POINT RD
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City | BRADENTON
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State | FL
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Zip | 34210-2128
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Country | US
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Telephone | 843-864-5018
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Fax |
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Provider Business Mailing Address
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Address Line | 4803 MANGROVE POINT RD
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City | BRADENTON
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State | FL
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Zip | 34210-2128
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Country | US
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Telephone | 843-864-5018
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Fax |
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Authorized Official
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Title or Position | FUNCTIONAL CERTIFIED NUTRITIONIST
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Name | DEBORAH RENEE' HUTCHINSON
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Credential | DCN
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Telephone | 843-864-5018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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