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General NPI Number Information
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NPI Number | 1477921278
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Entity Type | Individual
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Provider Name | LAURA KLOSSNER RD, LD
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Gender | Female
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 300 WINDING WOODS DR STE 206
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City | O FALLON
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State | MO
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Zip | 63366-4773
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Country | US
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Telephone | 816-505-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60677
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City | CHICAGO
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State | IL
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Zip | 60677-0900
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Country | US
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Telephone | 636-893-1356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2015030991
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License Number State | MO
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