Individual
MRS. STEPHANIE VICTORIA WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
Mailing address
405 W JACKSON ST, PO BOX 10000, CARBONDALE, IL 62901-1462
(618) 549-0721
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
16003186
IL
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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