Individual
JAEL STOCKBRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2622 HEARTLAND BLVD, IONIA, MI 48846-8757
(616) 522-0265
(616) 522-0298
Mailing address
233 S LINCOLN ST, PORTLAND, MI 48875-1426
(517) 647-2290
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/12/2009
Last updated
06/24/2011
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