Organization
ROSWELL NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN PORTER R.D., L,D. (REGISTERED DIETITIAN)
(404) 735-4850
Entity
Organization
Contact information
Practice address
5825 GLENRIDGE DR NE, BLDG 3, SUITE 101, ATLANTA, GA 30328-5387
(404) 735-4850
(678) 244-5350
Mailing address
5825 GLENRIDGE DR NE, BLDG 3, SUITE 101, ATLANTA, GA 30328-5387
(404) 735-4850
(678) 244-5350
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003732
GA
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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