Most Relevant Information
Provider Data
| NPI Number: | 1003837162 |
| Provider Name: | JILL LYNETTE GRIESBAUM MS, RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 553528 |
Most Important Dates
| Enumeration Date: | 07/22/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
600 N MAIN ST
MOUNT VERNON
MO
657121004
Practice Location Phone/Fax
| Phone: | 4174660187 |
| Fax: |
Provider Mailing Location
600 N MAIN ST
MOUNT VERNON
MO
657121004
Provider Mailing Phone/Fax
| Phone: | 4174660187 |
| Fax: |