Provider Demographics
NPI:1104266303
Name:MCCALL, LORI GARVIN (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:GARVIN
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 PHAROAH DR
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-7229
Mailing Address - Country:US
Mailing Address - Phone:803-743-3926
Mailing Address - Fax:
Practice Address - Street 1:401 KENSINGTON PL
Practice Address - Street 2:APT C
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2189
Practice Address - Country:US
Practice Address - Phone:803-743-3926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86009343133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered