Individual
GWINN S FIRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
213 S JEFFERSON ST, SUITE 416, ROANOKE, VA 24011-1705
(540) 224-5680
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
637207
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
637207
CERTIFICATION NUMBER
IL
Enumeration date
09/16/2006
Last updated
09/08/2021
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