Individual
PATRICIA A BOMKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LDN
Contact information
Practice address
5510 E STATE ST, ROCKFORD, IL 61108-2381
(815) 226-2000
Mailing address
5510 E STATE ST, ROCKFORD, IL 61108-2381
(815) 226-2000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164001219
IL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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