Provider Demographics
NPI:1477830149
Name:BRIGHT, EILEEN MARY (RD)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:MARY
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 COURIER PL
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-3806
Mailing Address - Country:US
Mailing Address - Phone:864-579-0417
Mailing Address - Fax:
Practice Address - Street 1:3060 REIDVILLE RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-5642
Practice Address - Country:US
Practice Address - Phone:864-576-5764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC359133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered