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General NPI Number Information
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NPI Number | 1043597040
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Entity Type | Individual
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Provider Name | DAVID LAWRENCE ELWOOD RATH MA, RD, LD
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Gender | Male
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2100 BROADWAY ST STE 101 SUITE 101
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City | LITTLE ROCK
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State | AR
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Zip | 72206-1363
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Country | US
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Telephone | 501-975-3662
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Fax | 501-508-6553
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Provider Business Mailing Address
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Address Line | 2100 BROADWAY ST STE 101
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City | LITTLE ROCK
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State | AR
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Zip | 72206-1363
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Country | US
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Telephone | 501-975-3662
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Fax | 501-508-6553
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 307
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License Number State | AR
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