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Individual

MRS. DEITRA A MORING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, LD

Contact information

Practice address
1 MEDICAL PARK DR, BENTON, AR 72015-3353
(501) 776-6051
(507) 776-6278
Mailing address
1 MEDICAL PARK DR, BENTON, AR 72015-3353
(501) 776-6051
(507) 776-6278

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
835
AR

Other

Enumeration date
01/21/2009
Last updated
01/21/2009
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