Individual
JEFFREY GARY BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDN
Contact information
Practice address
13901 E JEFFERSON AVE, DETROIT, MI 48215-2720
(313) 822-0900
Mailing address
13901 E JEFFERSON AVE, DETROIT, MI 48215-2720
(313) 822-0900
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86089803
MI
Other
Enumeration date
03/30/2020
Last updated
04/01/2020
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