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1154944288
KRISTINA STICKLEY
IDAHO FALLS, ID
NPI
1154944288
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: ID D-1127)
Enumeration Date
2020-05-22
Last Update Date
2020-05-22
Business Address
KRISTINA STICKLEY RDN, LD, CHES
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 208-529-6111
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Mailing Address
KRISTINA STICKLEY RDN, LD, CHES
3635 SILVERSTONE DR
IDAHO FALLS, ID 83401-3583
Phone number:
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