Provider Demographics
NPI:1477124048
Name:FETZER, DREW (RD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:FETZER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21940 MANZANITA FOREST DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9576
Mailing Address - Country:US
Mailing Address - Phone:530-401-2476
Mailing Address - Fax:
Practice Address - Street 1:21940 MANZANITA FOREST DR
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9576
Practice Address - Country:US
Practice Address - Phone:530-401-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered