Danielle Bach, LD

Individual provider Active NPI Registered Dietitian · Cairo, GA

NPI 1972948263 · NPPES record last updated May 1, 2013

Key facts

NPI
1972948263
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD004062 (GA)
Practice address
1155 5TH St SE
Cairo, GA 39828-3142
Phone
(229) 228-8800
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LD004062GAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD004062 GA Yes

Addresses

Primary practice location

1155 5TH St SE
Cairo, GA 39828-3142

Mailing address

1155 5TH St SE
Cairo, GA 39828-3142
Phone (229) 377-1150

Other identifiers

IdentifierTypeStateIssuer
LD004062OtherGALICENSE

Other providers in Cairo, GA

All providers in Cairo, GA · Registered Dietitian in Georgia

Sources for this page

Verify at the official NPI Registry.