Individual
TARA KETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
920 WEST ST, PERU, IL 61354-2763
(815) 780-3520
Mailing address
2607 PROSPECT ST, PERU, IL 61354-1563
(815) 883-1788
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86212286
IL
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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