DAN EDWARD BACON

DECATUR, GA
NPI1598808032
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: GA  ld002312)
Enumeration Date2007-02-15
Last Update Date2007-07-08
Business Address
-- DAN EDWARD BACON RD,LD
440 WINN WAY
DECATUR, GA 30030-1715
Phone number: 404-294-3762
Mailing Address
-- DAN EDWARD BACON RD,LD
440 WINN WAY
DECATUR, GA 30030-1715
Phone number: 404-294-3762
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