Individual
CARMEN KEALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12602 9TH ST, GARDEN GROVE, CA 92840
(714) 534-5965
Mailing address
12602 9TH ST, GARDEN GROVE, CA 92840
(714) 534-5965
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
806168
CA
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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