NPI 1114709573 · live from the CMS NPI Registry
Balanced Bites Nutrition LLC
Dietitian, Registered, Nutrition, Obesity and Weight Management in Eagle, ID. National Provider Identifier 1114709573, active.
NPI record
| NPI | 1114709573 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Obesity and Weight Management 133VN1201X |
| Practice location | 408 S Eagle Rd Ste 205, Eagle, ID 83616 |
| Practice phone | 208-954-0862 |
| Enumerated | October 19, 2023 |
| Last updated | November 21, 2024 |
| Authorized official | Tracy Bento, Registered Dietitian |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Obesity and Weight Management primary | 133VN1201X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.