| |
205 Radcliffe St, Bristol, PA 19007-5017 | |
(267) 540-3204 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Dietitian, Registered |
Location | 205 Radcliffe St, Bristol, Pennsylvania |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588918775 | NPI | - | NPPES |
244814 | Other | PA | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | DN004824 (Pennsylvania) | Primary |
Mailing Address | Practice Location Address |
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933 Radcliffe St, Bristol, PA 19007-5227 Ph: (267) 540-3204 | 205 Radcliffe St, Bristol, PA 19007-5017 Ph: (267) 540-3204 |