Individual
DELORES ANN GRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CSP, LD
Contact information
Practice address
4101 SOUTH 4TH ST TRAFFICWAY, LEAVENWORTH, KS 66048
(913) 682-2000
Mailing address
500 PAWNEE ST, LEAVENWORTH, KS 66048-1446
(913) 828-4980
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT 05446
TX
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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