Individual
SUSAN L SPIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
825 E MAIN ST STE C, MEDFORD, OR 97504-7171
(541) 245-0713
Mailing address
825 E MAIN ST STE C, MEDFORD, OR 97504-7171
(541) 245-0713
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
366
OR
Other
Enumeration date
08/03/2006
Last updated
07/16/2007
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