Individual
MRS. WENDY LYNN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., RDH
Contact information
Practice address
1415 MADISON AVE, DETROIT LAKES, MN 56501-4542
(218) 844-7161
Mailing address
1415 MADISON AVE, DETROIT LAKES, MN 56501-4542
(218) 844-7161
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2886
MN
133V00000X
Registered Dietitian
839
ND
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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