Doctor Name: | PROF. BRIAN D. CARROLL |
NPI Number: | 1558789479 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2014006008 |
Business Practice Address: | 1909 W Coolidge Ave Marion, IL - 629591097 |
Business Phone Number: | 6189975677 |
Business Fax Number: | |
Mailing Address: | 1718 Winery Rd, WEST FRANKFORT |
State: | IL |
Postal Code: | 628964907 |
Phone Number: | 6187270523 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2014 |
NPI Last Update Date: | 03/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 2014006008 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
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 |