Individual
STANLEY GENE PANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LD
Contact information
Practice address
1462 MONTREAL RD, SUITE 203, TUCKER, GA 30084-6929
(770) 674-5458
(770) 674-1871
Mailing address
1462 MONTREAL RD, SUITE 203, TUCKER, GA 30084-6929
(770) 674-5458
(770) 674-1871
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001886
GA
Other
Enumeration date
06/01/2006
Last updated
10/23/2007
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