Provider Demographics
NPI:1467029603
Name:GLASSCOCK, LYNZI (RDN)
Entity Type:Individual
Prefix:
First Name:LYNZI
Middle Name:
Last Name:GLASSCOCK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5126
Mailing Address - Country:US
Mailing Address - Phone:337-466-6899
Mailing Address - Fax:337-270-6305
Practice Address - Street 1:3320 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5126
Practice Address - Country:US
Practice Address - Phone:337-466-6899
Practice Address - Fax:337-270-6305
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered