Individual
MEREDITH L. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
911 BYPASS RD, PIKEVILLE, KY 41501-1689
(606) 218-3500
Mailing address
701 COURT ST, PAINTSVILLE, KY 41240-1086
(606) 789-2255
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1061
KY
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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