Individual
AJAY PHILIP KOLETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 W ELK AVE, ELIZABETHTON, TN 37643-2612
(423) 561-1623
Mailing address
220 W ELK AVE, ELIZABETHTON, TN 37643-2612
(423) 561-1623
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
TN
Other
Enumeration date
05/19/2022
Last updated
10/27/2022
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