Individual
MICAH WADDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 826-8833
Mailing address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 826-8833
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2012034588
MO
Other
Enumeration date
12/26/2012
Last updated
03/01/2024
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