Individual
JUDY LYNN ROUNTREE-BENEDICT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
VA SALT LAKE CITY HEALTH CARE SYSTEM, 500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148
(801) 582-1565
Mailing address
2915 E 3835 S, SALT LAKE CITY, UT 84109-3605
(801) 278-0358
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
102795-4901
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412574
NATIONAL REG DIETITIAN
—
Enumeration date
06/12/2006
Last updated
07/08/2007
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