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General NPI Number Information
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NPI Number | 1205710720
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Entity Type | Organization
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Legal Business Name | KELLY SPRINGER DIETITIAN NUTRITIONIST PLLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 7 ONONDAGA ST
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City | SKANEATELES
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State | NY
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Zip | 13152-1313
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Country | US
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Telephone | 315-730-4459
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Fax |
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Provider Business Mailing Address
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Address Line | 7 ONONDAGA ST
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City | SKANEATELES
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State | NY
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Zip | 13152-1313
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Country | US
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Telephone | 315-730-4459
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Fax | 844-364-4235
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | MRS. KELLY SPRINGER
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Credential | RD, CDN
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Telephone | 315-730-4459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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