Individual
MRS. JESSICA J DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-1294
(920) 623-1250
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-1294
(920) 623-1250
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2618 - 29
WI
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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