Individual
MADELYN BURK BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 BLYTHE BLVD STE 500, CHARLOTTE, NC 28203-5863
(704) 373-1813
Mailing address
1001 BLYTHE BLVD STE 500, CHARLOTTE, NC 28203-5863
(704) 373-1813
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L008240
NC
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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