Individual
KELLI JO WILMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
12847 STATE HIGHWAY YY, ELMO, MO 64445-8209
(660) 215-2046
Mailing address
12847 STATE HIGHWAY YY, ELMO, MO 64445-8209
(660) 215-2046
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
099245
IA
133V00000X
Registered Dietitian
2009028340
MO
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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