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Individual

ANNMARIE THACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDN, LD, CDCES

Contact information

Practice address
1865 TAMARACK RD, NEWARK, OH 43055-2305
(220) 564-4911
(220) 564-4919
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-3699
(220) 564-4911
(220) 564-4919

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
04/06/2020
Last updated
04/06/2020
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