Individual
JERAD DUMOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
732 HARRISON AVE, BOSTON, MA 02118-2309
(281) 636-9926
Mailing address
1 NASHUA ST APT 1409, BOSTON, MA 02114-1618
(281) 636-9926
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
LDN7037
MA
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
LDN7037
MA
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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