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Individual

LANETTE E GLASS KITCHINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8313 BRIXHAM CT, ANTELOPE, CA 95843-4564
(352) 425-4782
Mailing address
8313 BRIXHAM CT, ANTELOPE, CA 95843-4564
(352) 425-4782

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
171400000X
Health & Wellness Coach
174400000X
Specialist
2255A2300X
Athletic Trainer
Primary
CA

Other

Enumeration date
09/02/2021
Last updated
09/02/2021
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