Individual
ANTONIA M AHLGRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
801 N 4TH ST, BURLINGTON, KS 66839-2602
(620) 364-5655
Mailing address
801 N 4TH ST, BURLINGTON, KS 66839-2602
(620) 364-5655
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1092
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1092
KS LICENSE
KS
Enumeration date
12/31/2007
Last updated
04/27/2012
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