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Individual

MRS. COLLEEN ANN WRACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD,LD,CDE

Contact information

Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000

Taxonomy

Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
339
SC

Other

Enumeration date
11/06/2013
Last updated
02/06/2017
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