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Individual

JONATHAN BRAINARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, RD, CSSD, CSCS

Contact information

Practice address
7246 NIGHTSTALKER WAY, FORT CAMPBELL, KY 42223-5151
(270) 798-8727
Mailing address
7246 NIGHTSTALKER WAY, FORT CAMPBELL, KY 42223-5151

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
04/03/2023
Last updated
01/30/2024
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