Provider Demographics
NPI:1043597040
Name:RATH, DAVID LAWRENCE ELWOOD (MA, RD, LD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAWRENCE ELWOOD
Last Name:RATH
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Gender:M
Credentials:MA, RD, LD
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Other - First Name:
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Mailing Address - Street 1:401 W CAPITOL AVE
Mailing Address - Street 2:STE 702
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-3428
Mailing Address - Country:US
Mailing Address - Phone:501-975-3662
Mailing Address - Fax:501-975-3662
Practice Address - Street 1:401 WEST CAPITOL AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3495
Practice Address - Country:US
Practice Address - Phone:501-975-3662
Practice Address - Fax:501-975-3662
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2016-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR307133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered