Individual
CAROL E WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2090 N SUNNY LN, STAR, ID 83669-5118
(208) 794-8648
Mailing address
2090 N SUNNY LN, STAR, ID 83669-5118
(208) 794-8648
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D185
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0983730
—
ID
Enumeration date
04/16/2007
Last updated
05/07/2010
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