Individual
JACOB DUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
711 EAGLE PASS DR APT 318, CARTERVILLE, IL 62918-2056
(217) 994-4033
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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