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General NPI Number Information
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NPI Number | 1699217406
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Entity Type | Individual
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Provider Name | ANGELA WOLFENBERGER RDN
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Gender | Female
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 984 PIERCETOWN RD
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City | BUTLER
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State | TN
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Zip | 37640-5010
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Country | US
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Telephone | 917-747-4331
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 423
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City | MOUNTAIN CITY
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State | TN
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Zip | 37683-0423
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Country | US
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Telephone | 917-747-4331
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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