Thiboutot, Jeff R

Thiboutot, Jeff R is an individual health care provider with primary practice located at 952 E Baseline Rd Suite 119, Mesa AZ 85204-6627. He recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Nutrition, Education. Dietary & Nutritional Service Providers / Nutritionist is his primary health care specialty. Thiboutot, Jeff R can be contacted via phone (480) 539-4041.

Contact Information

Primary practice address
952 E Baseline Rd Suite 119 Mesa AZ 85204-6627
Phone: (480) 539-4041
Fax: (480) 539-4293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X

Profile Details

NPI number 1831398387
LBN Legal business name Thiboutot, Jeff R
Credentials B.S., C.N.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2007
Last updated Jul 15th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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