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Individual

MR. XAVIER JACOB LEE PEARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, RD, LD, CNSC

Contact information

Practice address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 328-6462
Mailing address
776 W PEARL ST, BOLIVAR, MO 65613-2878
(417) 298-1366

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2014031795
MO

Other

Enumeration date
08/05/2022
Last updated
08/05/2022
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