Organization
LAVANWAY NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN LAVANWAY RD,LD (OWNER)
(207) 862-2303
Entity
Organization
Contact information
Practice address
2A CONSTITUTION AVE, HAMPDEN, ME 04444-1330
(207) 862-2303
(207) 862-2303
Mailing address
2A CONSTITUTION AVE, HAMPDEN, ME 04444-1330
(207) 862-2303
(207) 862-2303
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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