Individual
KELLY BETH CSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
701 S HEALTH PKWY, THREE RIVERS, MI 49093-8352
(269) 278-1145
Mailing address
701 S HEALTH PKWY, THREE RIVERS, MI 49093-8352
(269) 278-1145
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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