Individual
JED JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D. L.D.
Contact information
Practice address
801 N BEDELL AVE, DEL RIO, TX 78840-4112
(830) 778-3655
(830) 778-3697
Mailing address
801 N BEDELL AVE, DEL RIO, TX 78840-4112
(830) 778-3655
(830) 778-3697
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06464
TX
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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