Individual
TRACIE VIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1421 BLUFF CREEK TRL, MONROE, GA 30656-8640
(404) 394-7038
Mailing address
1421 BLUFF CREEK TRL, MONROE, GA 30656-8640
(404) 394-7038
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD001209
GA
Other
Enumeration date
04/28/2019
Last updated
04/28/2019
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