Individual
MRS. DIANE SMITH ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
5765 KOWETA RD, COLLEGE PARK, GA 30349-1622
(770) 969-2556
(770) 969-2556
Mailing address
5765 KOWETA RD, COLLEGE PARK, GA 30349-1622
(770) 969-2556
(770) 969-2556
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003614
GA
Other
Enumeration date
11/13/2010
Last updated
11/13/2010
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