Provider Demographics
NPI:1881834547
Name:FRENCH, GREGORY LAWRENCE (RD, LD, CPT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:LAWRENCE
Last Name:FRENCH
Suffix:
Gender:M
Credentials:RD, LD, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4768 EMILY DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5227
Mailing Address - Country:US
Mailing Address - Phone:404-414-8642
Mailing Address - Fax:
Practice Address - Street 1:4768 EMILY DR SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-5227
Practice Address - Country:US
Practice Address - Phone:404-414-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002429133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered