NPI 1497060511 · live from the CMS NPI Registry
Amy M Bobalik, R.D.
Dietitian, Registered in Pierceton, IN. National Provider Identifier 1497060511, active.
NPI record
| NPI | 1497060511 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 5 Matchett Dr, Us Hwy 30 W, Pierceton, IN 46562 |
| Practice phone | 574-594-2136 |
| Mailing address | 1234 E Dupont Rd, Suite 1, Fort Wayne, IN 46825 |
| Enumerated | August 12, 2010 |
| Last updated | March 25, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 37001977A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.