Individual
KELLY PURYEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
2512 W PALM DR, TAMPA, FL 33629-7314
(508) 472-6098
Mailing address
2512 W PALM DR, TAMPA, FL 33629-7314
(508) 472-6098
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 7900
FL
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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