Provider Demographics
NPI:1952133522
Name:MOWAT, LINA M (RD)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:M
Last Name:MOWAT
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 1:8034 CRAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0004
Mailing Address - Country:US
Mailing Address - Phone:812-639-3191
Mailing Address - Fax:
Practice Address - Street 1:8034 CRAWLEY ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-0004
Practice Address - Country:US
Practice Address - Phone:812-639-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered