Individual
LISA GEBAUER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,CDN
Contact information
Practice address
111 MAIN ST, LOCKPORT, NY 14094-3718
(716) 438-4031
Mailing address
1058 E ROBINSON ST, NORTH TONAWANDA, NY 14120-4800
(716) 694-5112
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
R577673
NY
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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