Individual
KELLY D PANEITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
751 SAPPINGTON BRIDGE RD, MISSOURI BAPTIST HOSPITAL - SULLIVAN, SULLIVAN, MO 63080-2354
(573) 468-1347
(573) 468-1125
Mailing address
751 SAPPINGTON BRIDGE RD, MISSOURI BAPTIST HOSPITAL - SULLIVAN, SULLIVAN, MO 63080-2354
(573) 468-1347
(573) 468-1125
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2001012812
MO
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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