Individual
MRS. GWENDOLYN ROSE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
4 MEDICAL DR, ELBERTON, GA 30635-1830
(706) 283-3151
Mailing address
4230 SORRELLS BLVD, POWDER SPRINGS, GA 30127-4047
(678) 567-1928
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD001609
GA
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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