Individual
SARA SUZANNE UMPHFLEET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
1051 W SOUTH ST, KEWANEE, IL 61443-8354
(309) 852-7734
Mailing address
1051 W SOUTH ST, KEWANEE, IL 61443-8354
(309) 852-7734
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
086034
IA
133V00000X
Registered Dietitian
Primary
164007107
IL
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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