Individual
FRASER A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDN
Contact information
Practice address
348 MAPLE ST, GLEN ELLYN, IL 60137-3812
(630) 808-0804
Mailing address
348 MAPLE ST, GLEN ELLYN, IL 60137-3812
(630) 808-0804
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
164.008406
IL
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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