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NPI Code Detail

MEDICARE: MICHELE LAROCK MS RDN LDN

MEDICARE: MICHELE LAROCK MS RDN LDN
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
1133V00000XRegistered Dietitian1968MA

General Provider Information

NPI Number : 1477971323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE LAROCK MS RDN LDN
Provider Business Mailing Address
First Line : 12 SUNSET AVE
Second Line :
City : HATFIELD
State : MA
Zip : 01038-9716
Country : US
Telephone Number : 413-570-3281
Fax Number :
Provider Business Practice Location Address
First Line : 17 RESEARCH DR
Second Line :
City : AMHERST
State : MA
Zip : 01002-2788
Country : US
Telephone Number : 413-570-3281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2014
Last Update Date : 03/28/2014

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Directions to “ MICHELE LAROCK MS RDN LDN” Practice Location

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