Individual
MRS. ELLEN KATHLEEN SOURS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.D.,L.D.
Contact information
Practice address
4689 FULTON DR NW, CANTON, OH 44718-2379
(330) 649-9400
(330) 649-8059
Mailing address
4685 FULTON DR NW, CANTON, OH 44718-2379
(330) 649-9300
(330) 649-8058
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
1569
OH
Other
Enumeration date
06/25/2006
Last updated
07/08/2007
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