Individual
JENNIFER WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
2727 WINKLER AVE, FORT MYERS, FL 33901-9358
(239) 424-2168
Mailing address
13300 CORBEL CIR, APT 2326, FORT MYERS, FL 33907-6818
(720) 810-5839
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 7400
FL
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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