Individual
KELLY FALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, RD, LD, CNSC
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(800) 841-4938
Mailing address
2400 17TH ST, COLUMBUS, IN 47201-5351
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37003063A
IN
133V00000X
Registered Dietitian
LD.7412
OH
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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