Individual
AUDREY ELIZABETH PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
441 N WABASH AVE, MARION, IN 46952-2612
(765) 660-7133
Mailing address
1713 N QUARRY RD APT 224, MARION, IN 46952-1412
(765) 660-7133
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86007915
IN
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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