Organization
RENAL RD WV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN PATE MS RD CSR LD (OWNER)
(304) 617-4067
Entity
Organization
Contact information
Practice address
1811 COFFMAN ST, BARBOURSVILLE, WV 25504-2023
(304) 617-4067
Mailing address
1811 COFFMAN ST, BARBOURSVILLE, WV 25504-2023
(304) 617-4067
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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