Individual
JESSICA BROYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
620 DAVIS DR, NEW TAZEWELL, TN 37825
(423) 626-4291
Mailing address
620 DAVIS DR, NEW TAZEWELL, TN 37825-2152
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2071
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2071
REGISTERED DIETITIAN LICENSE NUMBER
TN
Enumeration date
01/28/2009
Last updated
05/15/2018
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