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Individual

DAN EDWARD BACON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD,LD

Contact information

Practice address
440 WINN WAY, DECATUR, GA 30030-1715
(404) 294-3762
(404) 508-7752
Mailing address
440 WINN WAY, DECATUR, GA 30030-1715
(404) 294-3762
(404) 508-7752

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002312
GA

Other

Enumeration date
02/15/2007
Last updated
07/08/2007
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