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Individual

BONNIE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LDLDMS

Contact information

Practice address
260 HOSPITAL DR, SOUTH WILLIAMSON, KY 41503-4072
(606) 237-1700
(606) 237-1701
Mailing address
260 HOSPITAL DR, SOUTH WILLIAMSON, KY 41503-4072
(606) 237-1700
(606) 237-1701

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
0793
KY
133V00000X
Registered Dietitian
Primary
429673
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0793
DIETITIANS AND NUTRITIONI
KY
Enumeration date
09/15/2005
Last updated
10/04/2007
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