Individual
MARTHA A BURNHAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
400 CHARTER BLVD, MACON, GA 31210-4831
(478) 757-6225
Mailing address
369 HINES TER, MACON, GA 31204-2417
(478) 743-5599
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000350
GA
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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