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General NPI Number Information
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NPI Number | 1417931882
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Entity Type | Individual
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Provider Name | PATRICIA CHERRY LDN
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Gender | Female
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 660 SUMMIT CROSSING PL SUITE #306
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City | GASTONIA
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State | NC
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Zip | 28054-2104
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Country | US
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Telephone | 704-671-7830
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Fax |
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Provider Business Mailing Address
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Address Line | 1316 MIDWOOD DR
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City | GASTONIA
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State | NC
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Zip | 28052-5255
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Country | US
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Telephone |
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Fax |
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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 | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | L000742
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License Number State | NC
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