Provider Demographics
NPI:1710556519
Name:SPRINGER, JODI (RDN, CLS)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:RDN, CLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 STREAMWATER CT
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-8129
Mailing Address - Country:US
Mailing Address - Phone:614-582-7601
Mailing Address - Fax:
Practice Address - Street 1:270 STREAMWATER CT
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-8129
Practice Address - Country:US
Practice Address - Phone:614-582-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH813959133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered