MEDICARE: CHAD JANKOWIAK R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1619381886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD JANKOWIAK R.D.

Provider Business Mailing Address
First Line	:	3138 CANTERBURY DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9250
Country	:	US
Telephone Number	:	989-280-7733
Fax Number	:

Provider Business Practice Location Address
First Line	:	3138 CANTERBURY DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9250
Country	:	US
Telephone Number	:	989-280-7733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2014
Last Update Date	:	06/16/2014

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Directions to “ CHAD JANKOWIAK R.D.” Practice Location

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