MEDICARE: LAURIE J PLACHINSKI RD

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	133V00000X	Registered Dietitian	LDN733	TN

General Provider Information

NPI Number	:	1588862429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE J PLACHINSKI RD

Provider Business Mailing Address
First Line	:	PO BOX 1788
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37901-1788
Country	:	US
Telephone Number	:	865-548-4892
Fax Number	:	865-549-2762

Provider Business Practice Location Address
First Line	:	5541 CLINTON HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-3475
Country	:	US
Telephone Number	:	865-281-2961
Fax Number	:	865-281-2964

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	07/08/2007

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