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General NPI Number Information
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NPI Number | 1851644918
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Entity Type | Organization
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Legal Business Name | NUTRITIONAL SERVICES OF SOUTHERN ARIZONA, INC.
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 850 N KOLB RD
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City | TUCSON
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State | AZ
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Zip | 85710-1333
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Country | US
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Telephone | 520-954-2551
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Fax | 520-393-3326
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Provider Business Mailing Address
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Address Line | 850 N KOLB RD
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City | TUCSON
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State | AZ
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Zip | 85710-1333
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Country | US
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Telephone | 520-954-2551
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Fax | 520-393-3326
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Authorized Official
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Title or Position | OWNER AND PRESIDENT
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Name | DR. MARY J PICCHIONI
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Credential | PH.D.
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Telephone | 520-954-2551
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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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