Organization
PURPOSELY FILLED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA GRAVES RD, CDCES (REGISTERED DIETITIAN/OWNER)
(573) 576-2723
Entity
Organization
Contact information
Practice address
704 W GRAND AVE, CAMPBELL, MO 63933-1406
(573) 576-2723
Mailing address
704 W GRAND AVE, CAMPBELL, MO 63933-1406
(573) 576-2723
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/14/2025
Last updated
11/14/2025
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