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General NPI Number Information
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NPI Number | 1548318967
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Entity Type | Individual
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Provider Name | CHRISTINE ROTH GUTELIUS R.D.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2523 STATE ROUTE 31
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City | WEEDSPORT
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State | NY
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Zip | 13166-3202
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Country | US
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Telephone | 315-834-6541
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Fax |
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Provider Business Mailing Address
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Address Line | 329 SUNSET BEACH DRIVE
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City | AUBURN
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State | NY
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Zip | 13021-9620
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Country | US
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Telephone | 315-253-2200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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