Individual
KATIE CLEGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2850 IRWIN DR, SOUTHPORT, NC 28461-8470
(862) 268-4375
(855) 701-1424
Mailing address
2850 IRWIN DR, SOUTHPORT, NC 28461-8470
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005453
NC
Other
Enumeration date
09/26/2020
Last updated
09/26/2020
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