Individual
KELLY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
46 MALLARDS CV, DUXBURY, MA 02332-3548
(781) 775-5994
Mailing address
46 MALLARDS CV, DUXBURY, MA 02332-3548
(781) 775-5994
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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