Organization
SOUTHERN OREGON NUTRITION & DIABETES TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L SPIVA RD, CDE (DIETITIAN/OWNER)
(541) 245-0713
Entity
Organization
Contact information
Practice address
825 E MAIN ST, SUITE C, MEDFORD, OR 97504-7133
(541) 245-0713
(541) 779-3526
Mailing address
825 E MAIN ST, SUITE C, MEDFORD, OR 97504-7133
(541) 245-0713
(541) 779-3526
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
366
OR
Other
Enumeration date
10/18/2006
Last updated
07/23/2007
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