Individual
LISA FUNK HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
4610 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3520
(336) 716-8234
Mailing address
5290 FUNK FARM LN, WINSTON SALEM, NC 27106-4586
(336) 287-5596
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L007465
NC
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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