Individual
KELLY WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
12245 N 1800TH ST, PALESTINE, IL 62451-2728
(618) 553-5467
Mailing address
12245 N 1800TH ST, PALESTINE, IL 62451-2728
(618) 553-5467
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005007
IL
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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