Provider Demographics
NPI:1336544220
Name:ORWIG, JODIE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:ORWIG
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S FRONT ST FL HALL11
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1621
Mailing Address - Country:US
Mailing Address - Phone:171-782-5283
Mailing Address - Fax:717-231-8823
Practice Address - Street 1:23 SEDGWICK DR
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-9349
Practice Address - Country:US
Practice Address - Phone:717-586-0415
Practice Address - Fax:717-763-2182
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000071133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered