Individual
ADAM LLOYD ILGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LRD
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2747
(573) 302-2755
Mailing address
1153 LINKS RD APT 24, OSAGE BEACH, MO 65065-2369
(814) 826-5293
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2022020051
MO
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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