Individual
MRS. MOLLY SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
400 JOHN DEERE RD, MOLINE, IL 61265-6898
(309) 762-0200
Mailing address
2514 3RD ST, MOLINE, IL 61265-5105
(309) 781-9446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
001928
IA
133VN1005X
Renal Nutrition Registered Dietitian
Primary
164005153
IL
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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