Healthcare Provider Details

I. General information

NPI: 1174179618
Provider Name (Legal Business Name): MEGHAN POLLNER RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3781 SOUTH HIGH STREET
COLUMBUS OH
43260-4011
US

IV. Provider business mailing address

2780 AIRPORT DR STE 100
COLUMBUS OH
43219-2289
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-3163
  • Fax: 614-645-5517
Mailing address:
  • Phone: 614-859-1906
  • Fax: 614-645-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberAPP-000281157
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: