Individual
AMY SUE CORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
1175 NININGER RD, HASTINGS, MN 55033-1056
(651) 480-4100
(651) 480-4212
Mailing address
15630 UPPER 194TH ST E, HASTINGS, MN 55033-9685
(651) 438-3348
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1857
MN
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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