Individual
KELLY ANNE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,CDE
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-6665
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-6665
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011102
NY
133VN1006X
Metabolic Nutrition Registered Dietitian
DO1266
MD
Other
Enumeration date
08/20/2009
Last updated
11/21/2022
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