Individual
STACY LYNN WELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD LD
Contact information
Practice address
500 MARKET ST, GRAFTON, WV 26354-1184
(304) 265-6436
Mailing address
500 MARKET ST, GRAFTON, WV 26354-1184
(304) 265-6436
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
481
WV
Other
Enumeration date
08/24/2007
Last updated
09/24/2008
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