Individual
MRS. TRACY JEANNINE PFAFFENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., C.D.
Contact information
Practice address
129 S HOME ST, MISHAWAKA, IN 46544-3134
(574) 256-9568
(574) 256-0817
Mailing address
129 S HOME ST, MISHAWAKA, IN 46544-3134
(574) 256-9568
(574) 256-0817
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37000231A
IN
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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