Courtney Tackett Fose, R.D., L.D.

NPI #1962742023 in Benton, Arkansas

Provider Information

NPI Number
1962742023
Entity Type
Individual
Name
Courtney Tackett Fose, R.D., L.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dietitian, Registered
Credential
R.D., L.D.
Enumeration Date
Feb 26, 2013
Last Updated
Feb 26, 2013

Practice Location

Address
1 MEDICAL PARK DR
City
Benton
ZIP Code
72015-3353
Phone
(501) 776-6052

Specialties & Taxonomy Codes

Specialty
Dietitian, Registered

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