Individual
MRS. SUSAN CARROLL KLEMENHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420
(541) 269-8182
(541) 266-7829
Mailing address
2355 OHIO, NORTH BEND, OR 97459
(541) 269-8182
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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