Individual
MS. DEBBIE A TILLOTSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 786-6268
Mailing address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 786-6268
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
199
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199
DIETICIAN
KS
Enumeration date
05/23/2006
Last updated
07/08/2007
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