Individual provider · NPI-1

Joyce Elaine Outlaw, R.D. L.D. M.S.

Dietitian, Registered · Dublin, GA

NPI number1275625089
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1275625089
Entity type
Individual (NPI-1)
Name
Joyce Elaine Outlaw
Credential
R.D. L.D. M.S.
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 29, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, RegisteredLD001552GAYes
133V00000X Dietitian, Registered30336IL

Practice location

1826 Veterans Blvd
Dublin, GA 31021-3620

Phone 478-272-1210

Mailing address

2201 Kings Dr
Dublin, GA 31021-2884

Phone 478-272-1210

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