Individual
MS. CYNTHIA SUE WALLERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
ONE FREEDOM WAY, MEDICAL CENTER ROUTING SYMBOL 295, AUGUSTA, GA 30904
(706) 733-0188
Mailing address
621 CARLTON DRIVE, AUGUSTA, GA 30909-3505
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001616
GA
Other
Enumeration date
10/04/2006
Last updated
07/10/2007
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