Individual
MEGAN FONCLARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1669 BRIDGE CREEK RD, TIGER, GA 30576-2070
(706) 982-9487
Mailing address
1669 BRIDGE CREEK RD, TIGER, GA 30576-2070
(706) 982-9487
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
LD005634
GA
363A00000X
Physician Assistant
Primary
12982
GA
Other
Enumeration date
11/26/2024
Last updated
03/18/2025
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