Individual
LORA L HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NDTR
Contact information
Practice address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 593-0245
Mailing address
110 DOWELL AVE, BELLEFONTAINE, OH 43311-2305
(937) 593-0245
(937) 592-9633
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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