Provider Demographics
NPI:1568234318
Name:ABBEY FOLSOM PLLC
Entity type:Organization
Organization Name:ABBEY FOLSOM PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ABBEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLSOM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CNS, LDN
Authorized Official - Phone:850-820-3837
Mailing Address - Street 1:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32302-0495
Mailing Address - Country:US
Mailing Address - Phone:850-820-3837
Mailing Address - Fax:
Practice Address - Street 1:1414 PIEDMONT DR E STE 100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7967
Practice Address - Country:US
Practice Address - Phone:850-820-3837
Practice Address - Fax:850-203-4429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty