Healthcare Provider Details

I. General information

NPI: 1265699391
Provider Name (Legal Business Name): FLORENCE SCHERMER RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20398 NEW GAMBIER RD
GAMBIER OH
43022-9654
US

IV. Provider business mailing address

20398 NEW GAMBIER RD
GAMBIER OH
43022-9654
US

V. Phone/Fax

Practice location:
  • Phone: 740-427-3298
  • Fax: 740-427-3298
Mailing address:
  • Phone: 740-427-3298
  • Fax: 740-427-3298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number983
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: