Basic Information
| Provider Information | |||||||||
| NPI: | 1184661001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPICHER | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DIETICIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 COLUMBIA AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176034154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173972738 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2301 COLUMBIA AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176034154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173972738 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 01/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | DN001329 | PA | Y | Dietary & Nutritional Service Providers | Nutritionist |
No ID Information.