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General NPI Number Information
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NPI Number | 1679323885
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Entity Type | Organization
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Legal Business Name | PURSUIT DIETETICS, PLLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 19750 MT HIGHWAY 91 N
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City | GLEN
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State | MT
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Zip | 59732-8507
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Country | US
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Telephone | 406-868-8915
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 922
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City | BOZEMAN
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State | MT
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Zip | 59771-0922
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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 | CAILYN GILLIS
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Credential | RD, LN
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Telephone | 406-868-8915
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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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