Individual
LYNN UNROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 SEQUOIA CIR, FORT BRAGG, CA 95437-5466
(707) 964-1251
(707) 961-2722
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
017391
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017391
DIETITIAN
CA
01
—
ZZZ24984Z
PPIN
CA
Enumeration date
08/28/2009
Last updated
08/28/2009
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