Individual
AMY FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2630 E 7TH ST, CHARLOTTE, NC 28204-4318
(704) 355-9484
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005524
NC
Other
Enumeration date
07/31/2019
Last updated
03/29/2021
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