Individual
SARA KATE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
(304) 388-5432
Mailing address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
(304) 388-5432
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86292865
WV
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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