Cedric R Waller
Nutritionist, Nutrition, Education in Kannapolis, NC. Individual provider (NPI-1).
NPI number1639824907
StatusActive
Last updated in NPPESFeb 15, 2022
Details
- NPI
- 1639824907
- Entity type
- Individual (NPI-1)
- Name
- Cedric R Waller
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 15, 2022
- Certification date
- Feb 1, 2022
- Last updated
- Feb 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133NN1002X | Nutritionist, Nutrition, Education | – | – | Yes |
Practice location
171 Ashmount DrKannapolis, NC 28081
Phone 901-491-5007
Mailing address
171 Ashmount DrKannapolis, NC 28081
Phone 901-491-5007
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