Individual
LANA TOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN, LD
Contact information
Practice address
281 PINE HAVEN DR, SAINT JOHNS, FL 32259-7403
(347) 682-0387
Mailing address
281 PINE HAVEN DR, SAINT JOHNS, FL 32259-7403
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
12/20/2023
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