Individual
MRS. CAITLIN M KOWNACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1400 W PARK ST, URBANA, IL 61801-2334
(217) 337-4520
Mailing address
2319 OSAGE DR, CHAMPAIGN, IL 61821-6346
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005506
IL
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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