Individual
MRS. GEORGANNE MACKULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
565 COAL VALLEY RD, JEFFERSON HILLS, PA 15025-3703
(412) 469-5797
(412) 469-7725
Mailing address
141 RIDGEWOOD RD, MOON TOWNSHIP, PA 15108-2444
(412) 469-5797
(412) 469-7725
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN001493
PA
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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