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General NPI Number Information
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NPI Number | 1841632866
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Entity Type | Organization
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Legal Business Name | FOOD CONNECTION LLC
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 06/06/2026
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Provider Practice Location Address
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Address Line | 3425 CLIFF SHADOWS PKWY STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89129-5113
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Country | US
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Telephone | 702-664-1204
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Fax | 702-537-7114
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Provider Business Mailing Address
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Address Line | 3425 CLIFF SHADOWS PKWY STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89129-5113
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Country | US
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Telephone | 702-580-9742
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | MICHELLE MAZUROWSKI
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Credential | MS,RDN,LD,LPTA,CLT
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Telephone | 702-580-9742
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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 | NV20131346778
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License Number State | NV
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