Individual
KELLI IOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
4913 LIGHTHOUSE CT, WINSTON SALEM, NC 27127-6814
(704) 942-0471
Mailing address
4913 LIGHTHOUSE CT, WINSTON SALEM, NC 27127-6814
(704) 942-0471
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004094
NC
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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