Jeff R Thiboutot, B.S., C.N.

NPI #1831398387 in Mesa, Arizona

Provider Information

NPI Number: 1831398387
Entity Type: Individual
Name: Jeff R Thiboutot, B.S., C.N.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Nutritionist
Credential: B.S., C.N.
Enumeration Date: Jul 15, 2007
Last Updated: Jul 15, 2007

Practice Location

Address: 952 E BASELINE RD
Address 2: SUITE 119
City: Mesa
State: Arizona
ZIP Code: 85204-6627
Phone: (480) 539-4041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist	133N00000X	Primary
Nutritionist - Nutrition, Education — Nutrition, Education	133NN1002X

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