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General NPI Number Information
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NPI Number | 1497060123
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Entity Type | Organization
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Legal Business Name | WEB-RD, LLC
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2300 HOLCOMB BRIDGE RD STE 103-423
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City | ROSWELL
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State | GA
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Zip | 30076-3481
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Country | US
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Telephone | 470-731-9176
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Fax | 888-356-0405
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Provider Business Mailing Address
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Address Line | 2300 HOLCOMB BRIDGE RD STE 103-423
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City | ROSWELL
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State | GA
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Zip | 30076-3481
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Country | US
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Telephone | 470-731-9176
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Fax | 888-356-0405
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. EMILY PETERSON
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Credential | RDN
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Telephone | 470-731-9176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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