OrganizationActive
Your Dietitian LLC
NPI 1609104058 · Renal Nutrition Registered Dietitian · East Point, GA
Provider details
- NPI number
- 1609104058
- Entity type
- Organization
- Primary specialty
- Renal Nutrition Registered DietitianDietary & Nutritional Service Providers
- Organization subpart
- No
- Authorized official
- Genevieve Broomfield, Chief Operating Officer(770) 356-9468
- License
- LD001151 (GA)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Dietary & Nutritional Service Providers
Dietary & Nutritional Service Providers
Practice location
2758 Felton Dr
East Point, GA 30344-3604
Phone: (770) 356-9468
Fax: (678) 547-3156
Approximate (ZIP-level) locationGet directions
Mailing address
908 Needletop Ct
Mcdonough, GA 30253-4315
Registry dates
- Enumerated
- 2009-11-23
- Last updated
- 2009-11-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.