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NPI Code Detail

MEDICARE: ALYSON LAST RD, LD

MEDICARE: ALYSON LAST RD, LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1962018283
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSON LAST RD, LD
Provider Business Mailing Address
First Line : 5601 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-9001
Country : US
Telephone Number : 706-530-4339
Fax Number :
Provider Business Practice Location Address
First Line : 5601 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-9001
Country : US
Telephone Number : 706-530-4339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2020
Last Update Date : 04/20/2021

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Directions to “ ALYSON LAST RD, LD” Practice Location

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