| Bamboo Nutrition, Llc | |
|
2012 Cherry Hill Dr Ste 202b, Columbia, MO 65203-5882 | |
| (573) 343-4017 | |
| (573) 615-4443 |
| Full Name | Bamboo Nutrition, Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 2012 Cherry Hill Dr Ste 202b, Columbia, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639795727 | NPI | - | NPPES |
| 2017032772 | Other | MO | MISSOURI DIVISION OF PROFESSIONAL REGISTRATION |
| 2018035632 | Other | MO | MISSOURI DIVISION OF PROFESSIONAL REGISTRATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Bamboo Nutrition, Llc 2012 Cherry Hill Dr Ste 202b, Columbia, MO 65203-5882 Ph: (573) 343-4017 | Bamboo Nutrition, Llc 2012 Cherry Hill Dr Ste 202b, Columbia, MO 65203-5882 Ph: (573) 343-4017 |
William Logan Bradley, MS, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1600 E Broadway, Columbia, MO 65201 Phone: 573-815-3189 | |
Gloria J Owen, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 800 Hospital Dr, Columbia, MO 65201 Phone: 573-814-6000 | |
Ms. Karissa Suzanne Herndon, R.D., L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1101 Club Village Dr, Suite 101, Columbia, MO 65203 Phone: 573-447-4400 | |
Ms. Nadine Claire Freshman, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 800 Hospital Dr, Columbia, MO 65201 Phone: 573-814-6000 | |
Leann Robley, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1000 W Nifong Blvd Ste 220, Columbia, MO 65203 Phone: 573-884-8240 | |
Joshua Bowers, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 500 N Keene St Ste 305, Columbia, MO 65201 Phone: 573-884-8240 | |
Jennifer Tveitnes, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3100 W Broadway, Columbia, MO 65203 Phone: 573-447-0133 |