Individual
MARY SISTRUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3510 OLD WASHINGTON RD, SUITE #100, WALDORF, MD 20602-3233
(301) 609-5200
(301) 609-5220
Mailing address
3510 OLD WASHINGTON RD, SUITE #100, WALDORF, MD 20602-3233
(301) 609-5200
(301) 609-5220
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D01770
MD
Other
Enumeration date
10/05/2006
Last updated
04/28/2008
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