Individual
SANDRA STEWART DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1421 N. STATE ST., SUITE 203, JACKSON, MS 39202-1658
(601) 355-1234
(601) 718-2778
Mailing address
1421 N. STATE ST., SUITE 203, JACKSON, MS 39202-1658
(601) 355-1234
(601) 718-2778
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D0943
MS
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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