Individual
KELLY WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4028 MILNERS CRES, BIRMINGHAM, AL 35242-7302
(205) 613-2719
Mailing address
4028 MILNERS CRES, BIRMINGHAM, AL 35242-7302
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
871082
AL
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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