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1124500681
TANA D INGRAM
TEMPE, AZ
NPI
1124500681
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: 86069798)
Enumeration Date
2018-08-31
Last Update Date
2018-08-31
Business Address
-- TANA D INGRAM MS, RDN
1840 E BROADWAY RD
TEMPE, AZ 85282-1614
Phone number: 480-495-0314
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Mailing Address
-- TANA D INGRAM MS, RDN
22072 E PECAN DR
QUEEN CREEK, AZ 85142-4895
Phone number: 480-495-0314
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