Individual
ALYSSA FEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4602
Mailing address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4602
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3474
MN
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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