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1053819037
LISA GEBAUER SMITH
LOCKPORT, NY
NPI
1053819037
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: NY R577673)
Enumeration Date
2018-01-25
Last Update Date
2018-01-25
Business Address
LISA GEBAUER SMITH RD,CDN
111 MAIN ST
LOCKPORT, NY 14094-3718
Phone number: 716-438-4031
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Mailing Address
LISA GEBAUER SMITH RD,CDN
1058 E ROBINSON ST
NORTH TONAWANDA, NY 14120-4800
Phone number: 716-694-5112
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