Amy Allison

Individual provider Active NPI Registered Dietitian · Brockton, MA

NPI 1457718140 · NPPES record last updated Jan 26, 2016

Key facts

NPI
1457718140
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
1413 (MA)
Practice address
63 Main St
Brockton, MA 02301-4042
Phone
(508) 559-6699
Fax
(508) 559-5073
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1413MAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1413 MA Yes

Addresses

Primary practice location

63 Main St
Brockton, MA 02301-4042

Mailing address

63 Main St
Brockton, MA 02301-4042
Phone (508) 238-5397

Other providers in Brockton, MA

All providers in Brockton, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.