Individual
CHAD WESLEY EISENHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDN, LDN
Contact information
Practice address
3018 N PATTERSON ST, VALDOSTA, GA 31602-1711
(229) 433-7200
(229) 433-7235
Mailing address
3018 N PATTERSON ST, VALDOSTA, GA 31602-1711
(229) 433-7200
(229) 433-7235
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD005137
GA
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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