Individual
NICHOLAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD, RD
Contact information
Practice address
2049 E 100TH ST, CLEVELAND, OH 44195-0001
(216) 269-5942
Mailing address
2049 E 100TH ST, CLEVELAND, OH 44195-0001
(216) 269-5942
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
7055
OH
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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