Individual
KAITLYN JOY WERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
1880 VOLLINTINE AVE, MEMPHIS, TN 38107-3117
(330) 289-6277
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UH172907
DRIVERS LICENSE
OH
Enumeration date
08/02/2022
Last updated
08/02/2022
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