Individual
LAURA JEAN CANCEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
914 N DIXIE AVE STE 306, ELIZABETHTOWN, KY 42701-2537
(270) 769-1559
Mailing address
173 BYERLY BLVD, RADCLIFF, KY 40160-8788
(270) 312-5650
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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