Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 2471 | MN |
Y | 111NN1001X | Nutrition | X011464 | NY |
NPI | 1043247075 |
---|---|
Provider Name | Peggy Frank |
First Address | Owego, NY 13827-1420 |
Second Address | Owego, NY 13827-1420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 01/11/2007 |