Provider Demographics
NPI:1073354619
Name:MCGUIRE, JILL (RD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9703 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-7028
Mailing Address - Country:US
Mailing Address - Phone:248-701-8823
Mailing Address - Fax:
Practice Address - Street 1:9703 TOWER RD
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-7028
Practice Address - Country:US
Practice Address - Phone:248-017-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered