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Individual

MRS. CAROL LYNN SHRIVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN

Contact information

Practice address
402 E ETHEL ST, SAINT JOSEPH, IL 61873-9004
(217) 778-7558
Mailing address
402 E ETHEL ST, SAINT JOSEPH, IL 61873-9004
(217) 778-7558

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.001441
IL

Other

Enumeration date
01/05/2007
Last updated
07/08/2007
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