Individual
MARILYN BURTON KOWALCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, SCD, LDN
Contact information
Practice address
1001 BLYTHE BLVD STE 300, CHARLOTTE, NC 28203-5863
(704) 373-0212
(704) 373-1216
Mailing address
PO BOX 60122, CHARLOTTE, NC 28260-0122
(704) 373-0212
(704) 373-1216
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L000866
NC
Other
Enumeration date
08/29/2006
Last updated
02/06/2009
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