Individual
TANA N CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
1 BURDICK EXPY W, MINOT, ND 58701-4406
(701) 857-5015
(701) 857-5646
Mailing address
1 BURDICK EXPY W, MINOT, ND 58701-4406
(701) 857-5015
(701) 857-5646
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
713
ND
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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