Individual
MRS. KRISTIN A. KWAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.N.
Contact information
Practice address
4950 YORK RD, SUITE 2D-1, HOLICONG, PA 18928-6000
(267) 879-5148
Mailing address
PO BOX 404, HOLICONG, PA 18928-0404
(267) 879-5148
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN001674
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723015
DIETETIC REGISTRATION NUM
—
Enumeration date
04/13/2007
Last updated
07/08/2007
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