Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 5932 | MO |
NPI | 1497844195 |
---|---|
Provider Name | Dr. Richard Vincent Kayser |
First Address | Jefferson City, MO 65109-2569 |
Second Address | Jefferson City, MO 65109-2569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 28/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U17430 | (02) | MO |