Organization
JESSY BRINLING NUTRITION LLC
Active
Other names
Great Lakes Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ELAINE LAKE MS, RDN, LD (REGISTERED DIETITIAN)
(814) 580-8808
Entity
Organization
Contact information
Practice address
3910 CAUGHEY RD STE 200, ERIE, PA 16506-4098
(814) 580-8808
Mailing address
3910 CAUGHEY RD STE 200, ERIE, PA 16506-4098
(814) 580-8808
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
09/25/2024
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