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General NPI Number Information
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NPI Number | 1437015724
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Entity Type | Organization
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Legal Business Name | ANITA DOCK RD LD LLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 4881 COOPER RD
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City | CINCINNATI
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State | OH
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Zip | 45242-6902
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Country | US
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Telephone | 513-417-4769
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Fax | 513-938-1986
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Provider Business Mailing Address
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Address Line | 3589 CARPENTERS GREEN LN
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City | BLUE ASH
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State | OH
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Zip | 45241-3222
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Country | US
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Telephone | 513-417-4769
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Fax | 513-938-1986
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Authorized Official
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Title or Position | OWNER/DIETITIAN
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Name | MRS. ANITA L DOCK
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Credential | RDN
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Telephone | 513-417-4769
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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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