Individual
JAVIER EDUARDO AZCARATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
172 THREE RIVERS DR NE, ROME, GA 30161-4999
(706) 234-6905
(706) 291-7792
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003853
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003129910A
—
GA
Enumeration date
02/20/2012
Last updated
05/07/2013
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