Individual
TRACY PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
195 BROADWAY, 195 BROADWAY, NEWPORT, RI 02840-2610
(617) 756-0082
Mailing address
195 BROADWAY, 195 BROADWAY, NEWPORT, RI 02840-2610
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1103367
RI
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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