Individual
KATHY M PETOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4721 8TH ST, APT. 11211, EAST MOLINE, IL 61244-5111
(309) 792-4553
Mailing address
4721 8TH ST, APT. 11211, EAST MOLINE, IL 61244-5111
(309) 792-4553
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005486
IL
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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