Provider Demographics
NPI:1255630703
Name:SAUTTER, JEFFREY M (RD, LDN)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:M
Last Name:SAUTTER
Suffix:
Gender:M
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1229
Mailing Address - Country:US
Mailing Address - Phone:413-475-3707
Mailing Address - Fax:
Practice Address - Street 1:12 LONG AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1229
Practice Address - Country:US
Practice Address - Phone:413-475-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2700133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered