Individual
MATTHEW D POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDN
Contact information
Practice address
3609 14TH AVE, COLUMBUS, GA 31904-7840
(440) 623-3194
Mailing address
3609 14TH AVE, COLUMBUS, GA 31904-7840
(440) 623-3194
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
GA
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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