Individual
DANIEL TICONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDN
Contact information
Practice address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-5811
Mailing address
1094 MAPLE RIDGE CT, EVANS, GA 30809-5248
(636) 614-5251
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2019029807
MO
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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