Individual
MR. MICHAEL MANSUETO LEIDIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Contact information
Practice address
33 KENT ST, UNIT 6, BROOKLINE, MA 02445-7977
(617) 240-4772
Mailing address
33 KENT ST, UNIT 6, BROOKLINE, MA 02445-7977
(617) 240-4772
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
668
MA
Other
Enumeration date
01/05/2009
Last updated
01/05/2009
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