Individual
CARNIE S DATRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
460 MARKET ST, THE WILLIAMSPORT BUILDING SUITE 212, WILLIAMSPORT, PA 17701-6385
(570) 745-3776
(570) 745-3776
Mailing address
460 MARKET ST, THE WILLIAMSPORT BUILDING SUITE 212, WILLIAMSPORT, PA 17701-6385
(570) 745-3776
(570) 745-3776
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004977
PA
Other
Enumeration date
11/15/2012
Last updated
12/11/2013
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