Individual
RYAN MATTHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LD
Contact information
Practice address
201 2ND ST STE 1100, MACON, GA 31201-6328
(714) 878-6590
Mailing address
200 CHARTER LN APT 1110, MACON, GA 31210-0535
(714) 878-6590
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86100374
—
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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