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Organization

LACY DAVIDSON, MS, RDN, LD, RYT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LACY MICHELLE DAVIDSON MS,RDN,LD,CDE,RYT (OWNER)
(304) 633-0675
Entity
Organization

Contact information

Practice address
162 HONEYSUCKLE LN, HUNTINGTON, WV 25701-4726
(304) 633-0675
(304) 405-2142
Mailing address
162 HONEYSUCKLE LN, HUNTINGTON, WV 25701-4726
(304) 633-0675
(304) 405-2142

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
934
WV

Other

Enumeration date
01/25/2016
Last updated
09/15/2016
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