MRS. SHANNON WIEDERHOLT, RD,LDN,CDE

Dietitian, Registered

Active Individual
NPI: 1972647287

Practice Address

408 N STATE OF FRANKLIN RD
SUITE#31
Johnson City, TN 37604

Phone: (423) 461-8880

Specialties

Specialty Code Primary License
Dietitian, Registered 133V00000X Yes 1075 (TN)

Frequently Asked Questions

NPI 1972647287 is the National Provider Identifier for MRS. SHANNON WIEDERHOLT, RD,LDN,CDE, a Dietitian, Registered provider located in Johnson City, TN. This NPI was enumerated on February 19, 2007.
MRS. SHANNON WIEDERHOLT, RD,LDN,CDE practices at 408 N STATE OF FRANKLIN RD, SUITE#31, Johnson City, TN 37604.

Quick Facts

NPI
1972647287
Type
Individual
Enumerated
Feb 19, 2007
Last Updated
Jul 8, 2007

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