Organization
LYNISE PERRY NUTRITION
Active
Other names
Lynise Perry Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
LYNISE PERRY CNS, LDN (NUTRITIONIST)
(630) 812-8584
Entity
Organization
Contact information
Practice address
557 RIVER CREEK RD, CHESAPEAKE, VA 23320-6233
(630) 812-8584
Mailing address
557 RIVER CREEK RD, CHESAPEAKE, VA 23320-6233
(630) 812-8584
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770065922
—
VA
Enumeration date
08/04/2019
Last updated
08/04/2019
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