MEDICARE: ASHLEE BOBRICK MS, RDN, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian	LD.09148	OH

General Provider Information

NPI Number	:	1376254680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEE BOBRICK MS, RDN, LD

Provider Business Mailing Address
First Line	:	2050 KENNY RD STE 1222
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3502
Country	:	US
Telephone Number	:	419-266-5133
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 KENNY RD STE 1222
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3502
Country	:	US
Telephone Number	:	419-266-5133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	12/07/2022

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