Individual
AVERY OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
414 HEDRICK ST, BUCKNER, MO 64016-9566
(816) 225-0725
Mailing address
414 HEDRICK ST, BUCKNER, MO 64016-9566
(816) 225-0725
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86083524
MO
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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