Individual
AMY BORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CD
Contact information
Practice address
4000 UNIVERSITY AVE, WATERLOO, IA 50701-5640
(319) 236-0580
Mailing address
4000 UNIVERSITY AVE, WATERLOO, IA 50701-5640
(319) 236-0580
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002125
IA
Other
Enumeration date
03/31/2010
Last updated
01/08/2014
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