Individual
MR. KENNETH JEFFERSON ALLEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Contact information
Practice address
2106 BARNETT AVE, WILMINGTON, NC 28403-2240
(910) 622-3096
Mailing address
2106 BARNETT AVE, WILMINGTON, NC 28403-2240
(910) 622-3096
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
004802
NC
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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