Individual
ELLEN C HOMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S, R.D., L.D.N
Contact information
Practice address
501 LAKE LAND BLVD, SUITE D, MATTOON, IL 61938-5283
(217) 258-3370
(217) 258-3379
Mailing address
501 LAKE LAND BLVD, SUITE D, MATTOON, IL 61938-5283
(217) 258-3370
(217) 258-3379
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.004542
IL
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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