Individual
KELLY LAZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-4011
Mailing address
526 N GRANT ST, 3A, BLOOMINGTON, IN 47408-3665
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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