Individual
PATRICIA L LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1243 S CEDAR CREST BLVD, STE 2200, ALLENTOWN, PA 18103-6268
(610) 402-5000
(610) 402-8539
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000672
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00216052
RAILROAD MEDICARE
PA
Enumeration date
04/14/2006
Last updated
12/18/2015
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