Individual
AMY MODRACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
134 THURBERS AVE, FAMILY SERVICE OF RHODE ISLAND, PROVIDENCE, RI 02905-4754
(401) 331-1350
(401) 277-3366
Mailing address
1440 PHILLIPS RD, NEW BEDFORD, MA 02745-1958
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN00543
RI
133V00000X
Registered Dietitian
RD657
MA
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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