Individual
JEEWON CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
(910) 907-8088
Mailing address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1037583
—
133V00000X
Registered Dietitian
L004065
NC
133V00000X
Registered Dietitian
LD003669
GA
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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