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MRS. BRIANA DUCKWORTH RD
>> Dietitian, Registered >> Dietary & Nutritional Service ProvidersRegistrant NPI Number: 1568123420
Individual Registrant:MRS. BRIANA DUCKWORTH RD
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
881 USS JAMES MADISON RD KINGS BAY, GA 31547-2531 US
Tel: 912-573-6576 Fax: --
Tel: 912-573-6576 Fax: --
Contact information for business:
881 USS JAMES MADISON RD KINGS BAY, GA 31547-2531 US
Tel: 912-573-6576 Fax: --
Tel: 912-573-6576 Fax: --
Registration Information:
NPI: 1568123420
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 133V00000X | Dietary & Nutritional Service Providers Dietitian, Registered | GA | LD00508 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| TRICARE | LD00508 | GA | 01 |
