NPI 1811249758

Transform Diet and Wellness Center, LLC

Organisation Dietary Manager Pewaukee, WI

Practice location

Address: 1231 George Towne Dr STE B, Pewaukee, WI 53072-2757
Phone: (262) 746-9088
Fax: (262) 746-9087

Authorised official

Name: Amelia Tollefson
Title: Nurse Practioner
Phone: (262) 746-9088

Registered specialties

Dietary Manager Primary

Dietary & Nutritional Service Providers Taxonomy 132700000X

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Registry record

NPI: 1811249758
Entity type: Organization
NPI issued: 2 Oct 2012
Record last updated: 2 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.