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KELLY GRACE ALDRICH R.D.

>> Dietitian, Registered >> Dietary & Nutritional Service Providers

Registrant NPI Number: 1730180142

Individual Registrant:
 KELLY GRACE ALDRICH R.D.
Gender: F

Location and contact information for practice:
6717 E 2ND ST STE. D PRESCOTT VALLEY, AZ 86314-2659 US
Tel: 928-771-3560  Fax: 928-771-3542

Contact information for business:
6717 E 2ND ST STE. D PRESCOTT VALLEY, AZ 86314-2659 US
Tel: 928-771-3560  Fax: 928-771-3542

Registration Information:
NPI: 1730180142
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
AZ853106

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
709701AZ05




HEALTH CARE JOBS AZ - Page 1



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