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Organization
DAKOTA DIETITIANS, LLC.
Active
Organization
DAKOTA DIETITIANS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN VAN DE WALLE MS, RD, LN (OWNER)
(605) 323-7222
Entity
Organization
Contact information
Practice address
1601 E 77TH ST APT 1428, SIOUX FALLS, SD 57108-3036
(605) 323-7222
Mailing address
PO BOX 210, SIOUX FALLS, SD 57101-0210
(605) 323-7222
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/08/2020
Last updated
03/31/2020
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