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Individual

BONNIE R LAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
213 S JEFFERSON ST, SUITE 416, ROANOKE, VA 24011-1705
(540) 224-5680
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
721066
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
721066
CERTIFICATION NUMBER
VA
Enumeration date
09/16/2006
Last updated
07/08/2007
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