Individual
JERIL ALTMIRE GOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.
Contact information
Practice address
145 HOSPITAL AVE, SUITE 104, DU BOIS, PA 15801-1462
(814) 375-3890
(814) 375-6388
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-3890
(814) 375-6388
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000996
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09810124
BOARD CERTIFICATION - NCBDE
PA
01
—
710814
RDN
PA
Enumeration date
01/08/2007
Last updated
08/11/2016
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