Individual
MRS. JILL LYNETTE GRIESBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
600 N MAIN ST, MOUNT VERNON, MO 65712-1004
(417) 466-0187
Mailing address
600 N MAIN ST, MOUNT VERNON, MO 65712-1004
(417) 466-0187
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
553528
MO
Other
Enumeration date
07/22/2006
Last updated
07/08/2007
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