Organization
CHAIN EFFECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GEORGE FITZGERALD RD, LDN (REGISTERED DIETITIAN)
(919) 594-1885
Entity
Organization
Contact information
Practice address
2501 BLUE RIDGE RD STE G130, RALEIGH, NC 27607-6347
(919) 594-1885
Mailing address
2501 BLUE RIDGE RD STE G130, RALEIGH, NC 27607-6347
(919) 594-1885
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005552
NC
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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