Individual
MARY KETTNER HANNUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
1515 S BYRNE RD, TOLEDO, OH 43614-3458
(419) 382-3475
Mailing address
1515 S BYRNE RD, TOLEDO, OH 43614-3458
(419) 382-3475
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2423
OH
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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