Individual
CANDISE JORDAN FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
2506 BALBOA ST, COLORADO SPRINGS, CO 80907-6934
(719) 425-5793
Mailing address
2506 BALBOA ST, COLORADO SPRINGS, CO 80907-6934
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1061751
AL
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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