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MS. KRISTA CARRIE CLARK RD LMNT

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

Registrant NPI Number: 1053352187

Individual Registrant:
MS. KRISTA CARRIE CLARK RD LMNT
Gender: F

Location and contact information for practice:
450 E 23RD ST  FREMONT, NE 68025-2303 US
Tel: 402-727-3726  Fax: 402-727-3433

Contact information for business:
450 E 23RD ST  FREMONT, NE 68025-2303 US
Tel: 402-727-3726  Fax: 402-727-3433

Registration Information:
NPI: 1053352187
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
NE633

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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