Organization
DOC NUTRITION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ZOLA MS, MSN, APRN (CEO/OWNER)
(203) 269-2852
Entity
Organization
Contact information
Practice address
185 CENTER ST, SUITE 1B, WALLINGFORD, CT 06492-4100
(203) 269-2852
(203) 269-9852
Mailing address
185 CENTER ST, SUITE 1B, WALLINGFORD, CT 06492-4100
(203) 269-2852
(203) 269-9852
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
07/06/2010
Last updated
07/10/2012
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