Individual
JENNIFER L CANGANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D.E.
Contact information
Practice address
2900 E BARNETT RD STE 2, MEDFORD, OR 97504-8380
(541) 789-5906
Mailing address
759 HILLDALE AVE, MEDFORD, OR 97504-8223
(352) 572-6503
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 3966
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297594
AVMED VENDOR NUMBER
FL
Enumeration date
07/25/2006
Last updated
07/21/2022
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