Individual
DANIELLE BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
1155 5TH ST SE, CAIRO, GA 39828-3142
(229) 228-8800
Mailing address
1155 5TH ST SE, CAIRO, GA 39828-3142
(229) 377-1150
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD004062
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD004062
LICENSE
GA
Enumeration date
05/01/2013
Last updated
05/01/2013
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