Provider Demographics
NPI:1780718122
Name:WITTMER, CHRIS E (RD,LD, CDE)
Entity type:Individual
Prefix:MRS
First Name:CHRIS
Middle Name:E
Last Name:WITTMER
Suffix:
Gender:F
Credentials:RD,LD, CDE
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELIZABETH
Other - Last Name:WITTMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD,LD,CDE
Mailing Address - Street 1:340 SAINT ANDREWS TRL
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-2799
Mailing Address - Country:US
Mailing Address - Phone:937-866-8141
Mailing Address - Fax:
Practice Address - Street 1:340 SAINT ANDREWS TRL
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-2799
Practice Address - Country:US
Practice Address - Phone:937-866-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0777133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered