Individual
NICOLE P BOMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
515 RICH ST, SLATER, MO 65349-1251
(660) 631-3598
Mailing address
515 RICH ST, SLATER, MO 65349-1251
(660) 631-3598
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2020020010
MO
Other
Enumeration date
07/27/2020
Last updated
12/02/2022
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