Individual
MRS. LISA RUDI-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
1835 S BROAD ST FL 1, PHILADELPHIA, PA 19148-2115
(215) 834-9463
Mailing address
1835 S BROAD ST FL 1, PHILADELPHIA, PA 19148-2115
(215) 834-9463
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DN002162
PA
133V00000X
Registered Dietitian
Primary
DN002162
PA
Other
Enumeration date
02/26/2014
Last updated
11/09/2018
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