Individual
SUSAN BERTUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 JUNIPER ST NE APT 502, ATLANTA, GA 30309-7656
(678) 984-3660
Mailing address
1101 JUNIPER ST NE APT 502, ATLANTA, GA 30309-7656
(678) 984-3660
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002858
GA
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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