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NPI Code Detail

MEDICARE: LAURA ASHLEY DILZ RD, LD

MEDICARE: LAURA ASHLEY DILZ RD, 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
1133V00000XRegistered DietitianLD7916OH

General Provider Information

NPI Number : 1700339496
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ASHLEY DILZ RD, LD
Provider Business Mailing Address
First Line : 2758 MARKBREIT AVE
Second Line : APT #1
City : CINCINNATI
State : OH
Zip : 45209-1922
Country : US
Telephone Number : 303-881-6697
Fax Number :
Provider Business Practice Location Address
First Line : 2651 OBSERVATORY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45208-2040
Country : US
Telephone Number : 303-881-6697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2016
Last Update Date : 07/28/2016

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Directions to “ LAURA ASHLEY DILZ RD, LD” Practice Location

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