Individual
MRS. MANDY LYNN PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., M.A., C.D.
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3345
(765) 747-3269
Mailing address
9577 W 400 N, FARMLAND, IN 47340-9392
(765) 468-6321
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/13/2006
Last updated
07/09/2007
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