Individual
MRS. GWENNA LYNN EGART
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
122A GORDON COMMERCIAL DR, LAGRANGE, GA 30240-5740
(706) 298-1510
Mailing address
418 SALEM RIDGE CT, MCDONOUGH, GA 30253-4780
(770) 954-4597
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001186
GA
Other
Enumeration date
09/01/2005
Last updated
07/08/2007
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