Individual
MRS. MARY AMANDA BERTALOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Mailing address
PO BOX 2429, SMYRNA, TN 37167-1719
(479) 443-4301
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
760
AR
Other
Enumeration date
10/28/2008
Last updated
06/22/2020
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