Individual
DERRICK CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
632 21ST AVE N, SOUTH SAINT PAUL, MN 55075-1504
(507) 573-3550
Mailing address
632 21ST AVE N, SOUTH SAINT PAUL, MN 55075-1504
(507) 573-3550
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86289524
MN
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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