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Individual

MS. CYNTHIA G BOYNTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICENSED DIETICIAN N

Contact information

Practice address
410 LINCOLN WAY EAST, MISHAWAKA, IN 46544
(574) 259-5653
(574) 259-5654
Mailing address
410 LINCOLN WAY EAST, MISHAWAKA, IN 46544
(574) 259-5653
(574) 259-5654

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
IL
133V00000X
Registered Dietitian
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01635133
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/15/2007
Last updated
08/15/2007
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