Individual
CALLIE TRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
401 BAPTIST DR STE 301, MADISON, MS 39110-2012
(601) 499-0935
(601) 499-0936
Mailing address
7731 OLD CANTON RD STE B, MADISON, MS 39110-6115
(601) 499-0935
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01527231
—
MS
Enumeration date
07/17/2019
Last updated
12/23/2019
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