Individual
KELLI MANTOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(208) 703-1850
Mailing address
2518 LELARAY ST, COLORADO SPRINGS, CO 80909-2405
(208) 703-1850
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/27/2025
Last updated
02/19/2025
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