PRUDENCE TICKNOR

MODESTO, CA
NPI1174920821
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: NC  819773)
Enumeration Date2014-11-24
Last Update Date2017-03-21
Business Address
-- PRUDENCE TICKNOR RD
1552 COFFEE RD SUITE 200
MODESTO, CA 95355-3122
Phone number: 209-248-7168
Mailing Address
-- PRUDENCE TICKNOR RD
1552 COFFEE RD SUITE 200
MODESTO, CA 95355-3122
Phone number: 209-248-7168
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