MR. Lawrence P Forman III, R.D.

NPI #1174553515 in Shiprock, New Mexico

Provider Information

NPI Number: 1174553515
Entity Type: Individual
Name: MR. Lawrence P Forman III, R.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: R.D.
Enumeration Date: Jul 3, 2006
Last Updated: Aug 14, 2008

Practice Location

Address: US HIGHWAY 491 NORTH
City: Shiprock
State: New Mexico
ZIP Code: 87420-0160
Phone: (505) 368-6204

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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