Provider Demographics
NPI:1811290869
Name:DANIEL, LIANG CHU KUNG (MS, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:LIANG CHU
Middle Name:KUNG
Last Name:DANIEL
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 1:11030 WEXFORD DR
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:TN
Mailing Address - Zip Code:38028-6934
Mailing Address - Country:US
Mailing Address - Phone:901-853-6368
Mailing Address - Fax:
Practice Address - Street 1:11030 WEXFORD DR
Practice Address - Street 2:
Practice Address - City:EADS
Practice Address - State:TN
Practice Address - Zip Code:38028-6934
Practice Address - Country:US
Practice Address - Phone:901-853-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN611225133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered