Organization
RURAL ROOTS NUTRITION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN H ALLEN MS, RD, CDN (SOLE PROPRIETOR/OWNER)
(315) 683-4263
Entity
Organization
Contact information
Practice address
1672 POMPEY CENTER RD, FABIUS, NY 13063-8703
(315) 683-4263
Mailing address
1672 POMPEY CENTER RD, FABIUS, NY 13063-8703
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
5036296
NY
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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