Individual
AMY E GHOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CSO, CNSC
Contact information
Practice address
2520 ELISHA AVE, ZION, IL 60099-2676
(847) 731-5093
Mailing address
2520 ELISHA AVE, ZION, IL 60099-2676
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.006277
IL
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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