Individual
KIMBERLY ANN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0002
(309) 672-4954
(309) 672-4953
Mailing address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0002
(309) 672-4954
(309) 672-4953
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164004335
IL
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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