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Dietary & Nutritional Service Providers Dietitian, Registered

Provider NPI: 1174508410

Organization Information:
Organization is Subpart
Authorized Official:  THOMAS L CORRIGAN  CFO  302-623-7203

Practice Location:
Tel: 302-623-4285  Fax: 302-623-4155

Business Mailing Address:
PO BOX 30170  WILMINGTON, DE 19805-7170 US
Tel: 302-623-7362  Fax: 302-623-7374

NPI Information:
NPI: 1174508410
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
Obstetrics & Gynecology
Physical Medicine & Rehabilitation
Orthopaedic Surgery
Obstetrics & Gynecology
Internal Medicine
Medical Genetics

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207VX0201X





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