Amy Louise Sample RD, LD

NPI 1790976173 - Dietitian, Registered - 133VN1004X

NPI Details
NPI 1790976173
Gender Female
Enumeration Date 08/09/2007
Last Updated 03/04/2016
Entity Type Individual
Active Over 9 years ago
Practice Location
4600 MEMORIAL DR
SUITE 120
BELLEVILLE IL, 62226-5368, US
Phone (618) 257-4644
Fax
Business Location
4500 MEMORIAL DRIVE
MEMORIAL HOSPITAL MEDICAL AFFAIRS
BELLEVILLE IL, 62226, US
Phone (618) 257-4644
Fax
Toxanomy
Taxonomy Code 133VN1004X
License State Texas
License Number DT80169
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According to our database, Mrs. Amy Louise Sample RD, LD NPI is 1790976173, taxonomy code is 133VN1004X and license number is DT80169, license state is located at Texas. Amy Louise Sample RD, LD physically located at 4600 Memorial Dr, Belleville IL, 62226-5368. NPI Number Amy Louise Sample RD, LD has the Individual type.

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1790976173 NPI number is provided on an as is basis without warranty of any kind. 1790976173 is maintained by the National Plan & Provider Enumeration System. The contents of Amy Louise Sample RD, LD are for informational purposes only.