Individual
MARY BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
3700 TUCKER DR, GREENVILLE, NC 27858-6000
(252) 757-1002
Mailing address
PO BOX 2944, GREENVILLE, NC 27836-0944
(252) 757-1002
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001046
NC
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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