Individual
ANDREA RUTH THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
1600 E JACKSON ST, MACOMB, IL 61455-2530
(309) 837-9917
Mailing address
1600 E JACKSON ST, MACOMB, IL 61455-2530
(309) 837-9917
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005111
IL
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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