NPI 1073791349

Jeremy R. Bennett, RD

Practitioner Registered Dietitian Racine, WI

Practice location

Address: 1320 Wisconsin Ave, Racine, WI 53403-1978
Phone: (262) 687-2781

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 1989-029 (WI)

Other Dietitian, Registered providers in Wisconsin →

Registry record

NPI: 1073791349
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Feb 2008
Record last updated: 8 Feb 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.