Doctor Name: | COREYANN K POLY |
NPI Number: | 1881800738 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 32 |
Business Practice Address: | 60 Quaker Hwy Uxbridge, MA - 015691628 |
Business Phone Number: | 5082787810 |
Business Fax Number: | |
Mailing Address: | 130 Elmshade Dr, UXBRIDGE |
State: | MA |
Postal Code: | 015692601 |
Phone Number: | 5082789713 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133VN1006X |
License Number: | 32 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | Nutrition, Metabolic |
Taxonomy Definition: |