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Individual

ALAN VANCE SIEWERTSEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
R.D.

Contact information

Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-9786
(904) 542-9117
Mailing address
650 TIMBERMILL LN, ORANGE PARK, FL 32065-2231
(904) 542-9796

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
01/25/2006
Last updated
07/08/2007
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