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General NPI Number Information
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NPI Number | 1750784153
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Entity Type | Organization
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Legal Business Name | DAILY NUTRITION LLC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 656 HARVEST DR
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City | BOLINGBROOK
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State | IL
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Zip | 60490-3142
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Country | US
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Telephone | 630-506-8369
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Fax | 888-528-3869
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Provider Business Mailing Address
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Address Line | 656 HARVEST DR
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City | BOLINGBROOK
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State | IL
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Zip | 60490-3142
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Country | US
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Telephone | 630-506-8369
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Fax | 888-528-3869
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Authorized Official
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Title or Position | MEMBER
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Name | MS. XIN ZHANG
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Credential |
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Telephone | 630-863-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198000402
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License Number State | IL
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