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General NPI Number Information
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NPI Number | 1093232472
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Entity Type | Organization
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Legal Business Name | LANCASTER NUTRITION, LLC
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 08/25/2017
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Provider Practice Location Address
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Address Line | 149 BEDDINGTON LN
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City | STRASBURG
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State | PA
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Zip | 17579-1453
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Country | US
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Telephone | 717-687-6804
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Fax |
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Provider Business Mailing Address
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Address Line | 149 BEDDINGTON LN
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City | STRASBURG
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State | PA
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Zip | 17579-1453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN, OWNER
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Name | AMANDA R TROUT
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Credential | MS, RDN, LDN
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Telephone | 717-687-6804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | DN003561
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License Number State | PA
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