Individual
CAROL DEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 HEALTH WAY DR, POTOSI, MO 63664-1420
(573) 438-5451
(573) 438-5460
Mailing address
300 HEALTH WAY DR, POTOSI, MO 63664-1420
(573) 438-5451
(573) 438-5460
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1001011692
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001011692
LICENSED DIETITIAN
MO
Enumeration date
02/11/2014
Last updated
02/11/2014
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