Individual
MRS. SHANNON MUCKENFUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN, CDE
Contact information
Practice address
165 S TRADE ST STE 2C, MATTHEWS, NC 28105-5771
(704) 846-7105
(704) 246-6808
Mailing address
1036 HUNTERS RUN DR, TEGA CAY, SC 29708-8339
(803) 448-6147
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L002479
NC
Other
Enumeration date
03/31/2014
Last updated
03/31/2014
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