Individual
MRS. AMY SUE MOOMAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
348 GRACE CORPENING DR, MARION, NC 28752-5864
(828) 559-2401
Mailing address
348 GRACE CORPENING DR, MARION, NC 28752-5864
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001880
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L001880
RD LICENSE
NC
Enumeration date
03/13/2018
Last updated
03/13/2018
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