Provider Demographics
NPI:1467148098
Name:JUMP, ARIC
Entity Type:Individual
Prefix:
First Name:ARIC
Middle Name:
Last Name:JUMP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:HOWARDS GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53083-1364
Mailing Address - Country:US
Mailing Address - Phone:920-627-9730
Mailing Address - Fax:
Practice Address - Street 1:1008 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:HOWARDS GROVE
Practice Address - State:WI
Practice Address - Zip Code:53083-1364
Practice Address - Country:US
Practice Address - Phone:920-627-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist