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Individual

DEANNA L FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDR

Contact information

Practice address
3655 MITCHELL ST, LORIS, SC 29569-9601
(843) 716-7000
(843) 716-7093
Mailing address
3655 MITCHELL ST., BOX 690001, LORIS, SC 29569-9601
(843) 716-7000
(843) 716-7093

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
864105
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
864105
CDR NUMBER
SC
Enumeration date
07/26/2007
Last updated
07/26/2007
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