Most Relevant Information
Provider Data
| NPI Number: | 1003506155 |
| Provider Name: | KEARSON PETRUZZI MS, RD, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | LD.10153 |
Most Important Dates
| Enumeration Date: | 05/11/2023 |
| Last Updated: | 05/11/2023 |
Provider Practice Location
186 E NORWICH AVE APT A
COLUMBUS
OH
432011233
Practice Location Phone/Fax
| Phone: | 3306218611 |
| Fax: |
Provider Mailing Location
186 E NORWICH AVE APT A
COLUMBUS
OH
432011233
Provider Mailing Phone/Fax
| Phone: | 3306218611 |
| Fax: |