Prudent-lifestyles Nutrition Services, Inc. | |
17570 San Rosa Blvd, Lathrup Village, MI 48076-2715 | |
(248) 866-4967 | |
(248) 559-5081 |
Full Name | Prudent-lifestyles Nutrition Services, Inc. |
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Type | Facility |
Speciality | Dietitian, Registered - Nutrition, Metabolic |
Location | 17570 San Rosa Blvd, Lathrup Village, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124228275 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133VN1006X | Dietitian, Registered - Nutrition, Metabolic | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Prudent-lifestyles Nutrition Services, Inc. 17570 San Rosa Blvd, Lathrup Village, MI 48076-2715 Ph: (248) 866-4967 | Prudent-lifestyles Nutrition Services, Inc. 17570 San Rosa Blvd, Lathrup Village, MI 48076-2715 Ph: (248) 866-4967 |
Ms. Erin Lee Fox, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 18161 W 12 Mile Rd Ste 2, Lathrup Village, MI 48076 Phone: 248-552-1200 | |
Ms. Tonja Maria Stallings, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 17570 San Rosa Blvd, Lathrup Village, MI 48076 Phone: 248-866-4967 Fax: 248-559-5081 |