Provider Demographics
NPI:1154906808
Name:IRISH, CHRISTOPHER ROLLIN (MS, RD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROLLIN
Last Name:IRISH
Suffix:
Gender:M
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 DIGHTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3241
Mailing Address - Country:US
Mailing Address - Phone:802-735-4306
Mailing Address - Fax:
Practice Address - Street 1:4 DIGHTON ST APT 2
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3241
Practice Address - Country:US
Practice Address - Phone:802-735-4306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered