Individual
JASON EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED DIETITIAN
Contact information
Practice address
HWY 72 NORTH, SALEM, MO 65560-0774
(573) 729-6626
(573) 729-6502
Mailing address
PO BOX 774, HWY 72 NORTH, SALEM, MO 65560-0774
(573) 729-6626
(573) 729-6502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2006001960
MO
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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