Individual
KACIE JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 N. FIRST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3474
Mailing address
221 WILLOW CT, EAST PEORIA, IL 61611-4654
(618) 521-5066
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004739
IL
Other
Enumeration date
12/20/2007
Last updated
05/27/2009
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