Individual
MRS. STACY JOHNSON WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
4007 MT GALLANT RD, ROCK HILL, SC 29732-9635
(803) 323-7505
Mailing address
4007 MT GALLANT RD, ROCK HILL, SC 29732-9635
(803) 323-7505
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
571
SC
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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