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General NPI Number Information
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NPI Number | 1487616801
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Entity Type | Individual
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Provider Name | JANE ELKAN KORSBERG M.S., R.D., L.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3909 ORANGE PL
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City | ORANGE VILLAGE
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State | OH
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Zip | 44122-4481
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Country | US
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Telephone | 440-349-3873
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Fax |
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Provider Business Mailing Address
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Address Line | 32700 S ROUNDHEAD DR
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City | SOLON
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State | OH
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Zip | 44139-4738
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Country | US
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Telephone | 440-349-3873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L3600
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License Number State | OH
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