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Individual

ELIZABETH FAYE PRUITT-WISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1670 CLAIMONT RD, DECATUR, GA 30033
(901) 592-9880

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2093
GA

Other

Enumeration date
05/31/2020
Last updated
05/31/2020
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