Most Relevant Information
Provider Data
| NPI Number: | 1003385196 |
| Provider Name: | SALLY ANN HARRYMAN RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/19/2018 |
| Last Updated: | 11/19/2018 |
Provider Practice Location
314 E MCKAY ST
FRONTENAC
KS
667632247
Practice Location Phone/Fax
| Phone: | 6202403416 |
| Fax: |
Provider Mailing Location
314 E MCKAY ST
FRONTENAC
KS
667632247
Provider Mailing Phone/Fax
| Phone: | 6202403416 |
| Fax: |