Individual
JACKSON RIEDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9822 N 1ST ST, PHOENIX, AZ 85020-1002
(320) 309-7399
Mailing address
9822 N 1ST ST, PHOENIX, AZ 85020-1002
(320) 309-7399
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
AZ
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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