| Doctor Name: | MRS. MARY ELIZABETH PETRIK |
| NPI Number: | 1922101286 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D. L. D. |
| License Number: | 280 |
| Business Practice Address: | 601 S Osage Caldwell, KS - 670221654 |
| Business Phone Number: | 6208456492 |
| Business Fax Number: | 6208456475 |
| Mailing Address: | 1007 W 160th St S, CALDWELL |
| State: | KS |
| Postal Code: | 670228601 |
| Phone Number: | 6208452984 |
| Fax Number: | 6208452986 |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 280 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| 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 |