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Individual

SANDRA D. PERNECKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
630 ARCHWOOD DR, ANN ARBOR, MI 48103-2807
(734) 741-8399
Mailing address
1215 N HURON RIVER DR, YPSILANTI, MI 48197-2351
(734) 487-3713

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
718222
ACADEMY OF NUTRITION AND DIETETICS
Enumeration date
10/04/2018
Last updated
10/04/2018
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