Individual
MRS. KELLI ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LDN
Contact information
Practice address
116 INTERSTATE PKWY, BRADFORD, PA 16701-1036
(814) 368-4143
(814) 362-8708
Mailing address
630 GREEVES ST, KANE, PA 16735-1522
(814) 837-8513
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN001025
PA
Other
Enumeration date
07/22/2005
Last updated
07/08/2007
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