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1154961779
DANIEL PEGRAM
CHARLOTTE, NC
NPI
1154961779
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: 86074561)
Enumeration Date
2020-01-11
Last Update Date
2020-01-11
Business Address
DANIEL PEGRAM RD
10400 MALLARD CREEK RD STE 340
CHARLOTTE, NC 28262-5203
Phone number: 704-549-9550
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Mailing Address
DANIEL PEGRAM RD
3412 VALLEY RD
WINSTON SALEM, NC 27106-2529
Phone number: 405-648-2121
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