Zack Kidd RD

NPI 1477987576 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1477987576
Gender Male
Enumeration Date 08/26/2013
Last Updated 08/26/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
510 E STONER AVE
SHREVEPORT LA, 71101-4243, US
Phone (318) 990-4084
Fax
Business Location
886 OAK GROVE CHURCH RD
GIBSLAND LA, 71028-4594, US
Phone (940) 255-9249
Fax
Toxanomy
Taxonomy Code 133V00000X
License State Louisiana
License Number 886
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According to our database, Zack Kidd RD NPI is 1477987576, taxonomy code is 133V00000X and license number is 886, license state is located at Louisiana. Zack Kidd RD physically located at 510 E Stoner Ave, Shreveport LA, 71101-4243. NPI Number Zack Kidd RD has the Individual type.

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1477987576 NPI number is provided on an as is basis without warranty of any kind. 1477987576 is maintained by the National Plan & Provider Enumeration System. The contents of Zack Kidd RD are for informational purposes only.