Individual
MARY JO BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CD
Contact information
Practice address
1617 E DIVISION ST, RIVER FALLS, WI 54022
(715) 307-6600
Mailing address
1617 E DIVISION ST, RIVER FALLS, WI 54022-1571
(715) 307-6600
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1826
WI
133V00000X
Registered Dietitian
2563
MN
Other
Enumeration date
07/24/2006
Last updated
03/15/2021
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