Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X006745-1 | NY |
NPI | 1003969080 |
---|---|
Provider Name | Lynn M. Allison |
First Address | Saratoga Springs, NY 12866-4307 |
Second Address | Saratoga Springs, NY 12866-4307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 08/07/2007 |