Individual
JORDAN D. MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
100 MERCY WAY, STE 580, JOPLIN, MO 64804-4524
(417) 556-8555
(417) 556-8553
Mailing address
100 MERCY WAY, STE 580, JOPLIN, MO 64804-4524
(417) 556-8555
(417) 556-8553
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
2015020189
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346622354
—
MO
Enumeration date
06/25/2015
Last updated
12/01/2016
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