Individual
COURTNEY TACKETT FOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
1 MEDICAL PARK DR, BENTON, AR 72015-3353
(501) 776-6052
Mailing address
138 LOTUS PL, HOT SPRINGS, AR 71901-9220
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1199
AR
Other
Enumeration date
02/26/2013
Last updated
02/26/2013
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