Kelley Blasa RD, LDN

NPI 1700055100 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1700055100
Gender Female
Enumeration Date 02/29/2008
Last Updated 02/29/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
11197 W LAKESHORE DR
HANNIBAL MO, 63401-7386, US
Phone (573) 221-1354
Fax
Business Location
11197 W LAKESHORE DR
HANNIBAL MO, 63401-7386, US
Phone
Fax
Toxanomy
Taxonomy Code 133V00000X
License State
License Number
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According to our database, Kelley Blasa RD, LDN NPI is 1700055100, taxonomy code is 133V00000X Kelley Blasa RD, LDN physically located at 11197 W Lakeshore Dr, Hannibal MO, 63401-7386. NPI Number Kelley Blasa RD, LDN has the Individual type.

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1700055100 NPI number is provided on an as is basis without warranty of any kind. 1700055100 is maintained by the National Plan & Provider Enumeration System. The contents of Kelley Blasa RD, LDN are for informational purposes only.