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Dietary & Nutritional Service Providers Dietary Manager

Provider NPI: 1215444039

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
557 W WASHINGTON ST  BURNS, OR 97720-1441 US
Tel: 541-573-7280  Fax: --

Business Mailing Address:
557 W WASHINGTON ST  BURNS, OR 97720-1441 US
Tel: 541-573-7281  Fax: --

NPI Information:
NPI: 1215444039
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N132700000XDietary & Nutritional Service Providers
Dietary Manager
N136A00000XDietary & Nutritional Service Providers
Dietetic Technician, Registered

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 174H00000X





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