Individual
SHANNON SUMMERS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
180 FERRUM MOUNTAIN RD, FERRUM, VA 24088-2939
(540) 365-4469
Mailing address
993 VISTA LN, HIAWASSEE, GA 30546-3980
(804) 543-9344
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L004590
NC
Other
Enumeration date
07/22/2015
Last updated
12/03/2021
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