Individual
MS. ELIZABETH GROSS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408-2952
(612) 979-2276
(651) 925-0427
Mailing address
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408-2952
(612) 979-2276
(651) 925-0427
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2952
MN
Other
Enumeration date
12/29/2010
Last updated
11/21/2019
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