Individual
WANDA W TUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
333 REVOLUTIONARY TRL, FAIRFAX, SC 29827-7109
(803) 632-2533
(803) 632-3757
Mailing address
333 REVOLUTIONARY TRL, FAIRFAX, SC 29827-7109
(803) 632-2533
(803) 632-3757
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
261
SC
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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