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MARY ELLEN EVERSON RD

>> Dietitian, Registered >> Dietary & Nutritional Service Providers

Registrant NPI Number: 1619384278

Individual Registrant:
 MARY ELLEN EVERSON RD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
49 LYME RD  HANOVER, NH 03755-1205 US
Tel: 610-715-0410  Fax: --

Contact information for business:
PO BOX 1072  NEW LONDON, NH 03257-1072 US
Tel: 610-715-0410  Fax: --

Registration Information:
NPI: 1619384278
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
NH0567

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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