Individual
CRYSTAL MARIE SHORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
5150 DAVIDSON ROAD, MARIETTA, GA 30068
(678) 209-8976
Mailing address
4880 LOWER ROSWELL RD, SUITE 165-142, MARIETTA, GA 30068-4375
(678) 209-8976
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003806
GA
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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