NPI 1235529827 · live from the CMS NPI Registry
Breanna Bock, RD
Dietitian, Registered in Grand Rapids, MI. National Provider Identifier 1235529827, active.
NPI record
| NPI | 1235529827 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2456 Foster Ave Ne, Grand Rapids, MI 49505 |
| Practice phone | 616-886-4885 |
| Enumerated | February 3, 2015 |
| Last updated | July 15, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 86043515 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.