Individual
MRS. LORIE LYNN SIDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
500 BURLINGTON RD, JACKSON, OH 45640-9360
(740) 395-8356
Mailing address
500 BURLINGTON RD, JACKSON, OH 45640-9360
(740) 395-8356
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD.09000
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0387812
—
OH
Enumeration date
12/10/2019
Last updated
09/25/2023
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