Individual
REBECCA JANE DISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
13273 SPRUCE RUN DR APT 311, NORTH ROYALTON, OH 44133-4284
(440) 227-4775
Mailing address
13273 SPRUCE RUN DR APT 311, NORTH ROYALTON, OH 44133-4284
(440) 227-4775
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1014155
OH
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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