| Doctor Name: | BRIAN HETRICH |
| NPI Number: | 1083978795 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | N.D. |
| License Number: | |
| Business Practice Address: | 101 Whisperwood Ct Abingdon, MD - 210091175 |
| Business Phone Number: | 4105692046 |
| Business Fax Number: | |
| Mailing Address: | 101 Whisperwood Ct, ABINGDON |
| State: | MD |
| Postal Code: | 210091175 |
| Phone Number: | 4105692046 |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2012 |
| NPI Last Update Date: | 06/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |