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Individual

SUSAN M MARTODAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LRD

Contact information

Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
(701) 234-2045
Mailing address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
(701) 234-2045

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2223
MN

Other

Enumeration date
07/18/2006
Last updated
09/16/2008
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