Individual
KAITLYN GREB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDLD
Contact information
Practice address
3023 PERRYTON PKWY STE 101, PAMPA, TX 79065-2817
(806) 665-0801
(806) 665-8503
Mailing address
PO BOX 1391, PANHANDLE, TX 79068-1391
(479) 518-0711
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT84769
LICENSE NUMBER
TX
Enumeration date
08/25/2017
Last updated
08/25/2017
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