Individual
MANDY KENYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2050 A SECOND ST SE, KIRTLAND AFB, NM 87117-1916
(760) 450-3107
Mailing address
2050 A SECOND ST SE, KIRTLAND AFB, NM 87117-0001
(760) 450-3107
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1050960
CA
Other
Enumeration date
11/06/2015
Last updated
04/07/2021
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