Individual
MRS. JANICE ILEEN GENGENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
300 E 12TH ST, COZAD, NE 69130-1505
(308) 784-2261
Mailing address
43540 ROAD 739, SMITHFIELD, NE 68976-1065
(308) 472-5092
(308) 472-5090
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
325
NE
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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