Individual
MADISON NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
614 BROWN ST, CHARLOTTESVILLE, VA 22903-4521
(616) 951-2102
Mailing address
614 BROWN ST, CHARLOTTESVILLE, VA 22903-4521
(616) 951-2102
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86292227
—
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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