Provider Demographics
NPI:1689211732
Name:LSM-NEWTRITION P.L.C.
Entity Type:Organization
Organization Name:LSM-NEWTRITION P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RDLD
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:SUTTON
Authorized Official - Last Name:MCNALLY
Authorized Official - Suffix:
Authorized Official - Credentials:MSRDLD
Authorized Official - Phone:501-529-0508
Mailing Address - Street 1:12010 TIMBER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-1725
Mailing Address - Country:US
Mailing Address - Phone:501-529-0508
Mailing Address - Fax:
Practice Address - Street 1:12010 TIMBER CREEK RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-1725
Practice Address - Country:US
Practice Address - Phone:501-529-0508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty