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Individual

SAMANTHA GRACE SELSOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RDN, LD

Contact information

Practice address
731 W RIVERSIDE ST, SPRINGFIELD, MO 65807-4658
(417) 612-4982
Mailing address
731 W RIVERSIDE ST, SPRINGFIELD, MO 65807-4658
(417) 612-4982

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2025030620
MO

Other

Enumeration date
09/18/2025
Last updated
09/18/2025
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