Organization
LYNISE PERRY NUTRITION
Active
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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