Most Relevant Information
Provider Data
| NPI Number: | 1003421132 |
| Provider Name: | MICHAEL RAYNOR MS, RD, LDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/15/2020 |
| Last Updated: | 03/23/2022 |
Provider Practice Location
1441 E BROAD ST STE 256
FUQUAY VARINA
NC
275261968
Practice Location Phone/Fax
| Phone: | 9197410730 |
| Fax: |
Provider Mailing Location
1441 E BROAD ST STE 256
FUQUAY VARINA
NC
275261968
Provider Mailing Phone/Fax
| Phone: | 9197410730 |
| Fax: |