Doctor Name: | KENDALL S. RAY |
NPI Number: | 1144694464 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RD |
License Number: | 86039872 |
Business Practice Address: | 7900 W Jefferson Blvd Suite 201 Fort Wayne, IN - 468044128 |
Business Phone Number: | 2604322297 |
Business Fax Number: | 2604792950 |
Mailing Address: | 7916 W Jefferson Blvd, FORT WAYNE |
State: | IN |
Postal Code: | 468044140 |
Phone Number: | 2604346071 |
Fax Number: | 2604346389 |
NPI Enumeration Date: | 11/24/2015 |
NPI Last Update Date: | 11/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 86039872 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |