Individual
MARY M MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
12458 MCGREGOR WOODS CIR, FORT MYERS, FL 33908-2459
(239) 454-4466
Mailing address
12458 MCGREGOR WOODS CIR, FORT MYERS, FL 33908-2459
(239) 454-4466
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND86
FL
Other
Enumeration date
01/17/2007
Last updated
09/17/2008
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