Most Relevant Information
Provider Data
| NPI Number: | 1003580002 |
| Provider Name: | WHITNEY PETTERBORG RDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86118135 |
Most Important Dates
| Enumeration Date: | 08/03/2021 |
| Last Updated: | 08/03/2021 |
Provider Practice Location
517 W 100 N STE 110
PROVIDENCE
UT
843329826
Practice Location Phone/Fax
| Phone: | 4357556075 |
| Fax: |
Provider Mailing Location
172 MEADOW CIR
LOGAN
UT
843215095
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |