Individual
MRS. JENNIFER S ETHERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
3198 PINEVIEW LN, METROPOLIS, IL 62960-6600
(618) 524-5798
Mailing address
3198 PINEVIEW LN, METROPOLIS, IL 62960-6600
(618) 524-5798
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1188
KY
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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