Individual
MR. JEFFERY LEE HEILESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 956-0621
Mailing address
1501 MUTUAL DR, CLARKSVILLE, TN 37042-7092
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003650
GA
Other
Enumeration date
10/26/2009
Last updated
09/03/2013
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