Individual
COLLEEN ANN MCGONIGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5030 BOND AVE, DREXEL HILL, PA 19026-4713
(610) 389-8599
Mailing address
5030 BOND AVE, DREXEL HILL, PA 19026-4713
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006029
PA
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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