Most Relevant Information
Provider Data
| NPI Number: | 1003423823 |
| Provider Name: | JEANNE THERESE LAIRD RDN LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 164.007610 |
Most Important Dates
| Enumeration Date: | 09/25/2020 |
| Last Updated: | 10/22/2020 |
Provider Practice Location
100 FITNESS DR
BOURBONNAIS
IL
609149584
Practice Location Phone/Fax
| Phone: | 8159366515 |
| Fax: | 8159366517 |
Provider Mailing Location
100 FITNESS DR
BOURBONNAIS
IL
609149584
Provider Mailing Phone/Fax
| Phone: | 8159366515 |
| Fax: | 8159366517 |