Individual
MRS. STACY JO MCCLINTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RD, CDN
Contact information
Practice address
90 PRESIDENTIAL PLZ, SYRACUSE, NY 13202-2240
(315) 464-4219
(315) 464-4218
Mailing address
750 E ADAMS ST, SUITE 2407, SYRACUSE, NY 13210-2306
(315) 464-4304
(315) 465-4301
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001947-1
NY
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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