Most Relevant Information
Provider Data
| NPI Number: | 1003423682 |
| Provider Name: | TENNY KUSSAT RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 809647 |
Most Important Dates
| Enumeration Date: | 09/28/2020 |
| Last Updated: | 09/28/2020 |
Provider Practice Location
655 PARK CENTER DR
SANTEE
CA
920713094
Practice Location Phone/Fax
| Phone: | 6195965575 |
| Fax: |
Provider Mailing Location
655 PARK CENTER DR
SANTEE
CA
920713094
Provider Mailing Phone/Fax
| Phone: | 6195965575 |
| Fax: |