Individual
MRS. KRISTINE NOEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
1471 DEWAR DR # 204, ROCK SPRINGS, WY 82901-5814
(919) 564-9064
(307) 316-0228
Mailing address
1010 ARROWHEAD CIR, ROCK SPRINGS, WY 82901-7288
(919) 564-9064
(307) 316-0228
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
117
WY
133VN1006X
Metabolic Nutrition Registered Dietitian
117
WY
Other
Enumeration date
07/03/2009
Last updated
12/12/2017
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