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1972647287
SHANNON M WIEDERHOLT
JOHNSON CITY, TN
NPI
1972647287
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: TN 1075)
Enumeration Date
2007-02-19
Last Update Date
2007-07-08
Business Address
Mrs. SHANNON M WIEDERHOLT RD,LDN,CDE
408 N STATE OF FRANKLIN RD SUITE#31
JOHNSON CITY, TN 37604-6089
Phone number: 423-461-8880
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Mailing Address
Mrs. SHANNON M WIEDERHOLT RD,LDN,CDE
408 N STATE OF FRANKLIN RD SUITE#31
JOHNSON CITY, TN 37604-6089
Phone number: 423-461-8880
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