Individual
KELLEY N GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
117 E CLARK ST, HARRISBURG, IL 62946-2702
(618) 252-8625
Mailing address
117 E CLARK ST, HARRISBURG, IL 62946-2702
(618) 252-8625
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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