Individual
MRS. HEIDI COLLEEN CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1992 PATTERSON MOUNTAIN RD, MEADOW BRIDGE, WV 25976-6914
(773) 459-3700
Mailing address
1992 PATTERSON MOUNTAIN RD, MEADOW BRIDGE, WV 25976-6914
(773) 459-3700
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1099
WV
Other
Enumeration date
10/09/2021
Last updated
10/09/2021
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