Doctor Name: | SCOTT BLANK |
NPI Number: | 1194818732 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S., R.D., L.D.N. |
License Number: | |
Business Practice Address: | 5409 North Knoxville Ave. Proctor Hospital Peoria, IL - 61614 |
Business Phone Number: | 3096911056 |
Business Fax Number: | 3096896010 |
Mailing Address: | 5409 North Knoxville Ave., Proctor Hospital PEORIA |
State: | IL |
Postal Code: | 61614 |
Phone Number: | 3096911056 |
Fax Number: | 3096896010 |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |