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General NPI Number Information
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NPI Number | 1447734926
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Entity Type | Organization
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Legal Business Name | SOUTH HILLS NUTRITION LLC
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 300 MOUNT LEBANON BLVD STE 209C
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City | PITTSBURGH
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State | PA
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Zip | 15234-1507
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Country | US
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Telephone | 412-720-3343
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Fax |
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Provider Business Mailing Address
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Address Line | 120 RIDGWAY CT
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City | PITTSBURGH
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State | PA
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Zip | 15228-1730
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Country | US
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Telephone | 412-720-3343
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JODY GARLICK
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Credential | RDN
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Telephone | 412-720-3343
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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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