Individual
MRS. JENNIFER ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
419 E DONALD ST, WATERLOO, IA 50703-1500
(319) 236-1911
(319) 287-5832
Mailing address
419 E DONALD ST, WATERLOO, IA 50703-1500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001817
IA
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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