Organization
REAL FOOD CHARLOTTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNETTE T HABECKER RD,LDN (PRESIDENT)
(407) 408-7242
Entity
Organization
Contact information
Practice address
6135 PARK SOUTH DR, CHARLOTTE, NC 28210-3272
(407) 408-7242
Mailing address
5501 HOLYOKE LN, CHARLOTTE, NC 28226-6898
(407) 408-7242
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L003989
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053664383
NPPES
NC
05
—
DT1060
—
NC
Enumeration date
06/29/2016
Last updated
06/29/2016
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