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Individual

MR. GARY ALAN YOUNGBLOOD JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RD, LD, CDE

Contact information

Practice address
141 NANDINA WAY, POOLER, GA 31322-4076
(912) 660-1215
Mailing address
141 NANDINA WAY, POOLER, GA 31322-4076
(912) 660-1215

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002323
GA

Other

Enumeration date
09/24/2009
Last updated
09/24/2009
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