Individual
JILL AUBEY GRANNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1 HOSPITAL DR, DC 120.00, COLUMBIA, MO 65212-0001
(573) 882-2017
Mailing address
1 HOSPITAL DR, DC 120.00, COLUMBIA, MO 65212-0001
(573) 882-2017
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2009026691
MO
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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