Individual
MRS. TINA R WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5192
(573) 632-5879
Mailing address
909 AMETHYST LN, JEFFERSON CITY, MO 65109-6854
(573) 634-7873
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2001023574
MO
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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