Individual
MR. ANTHONY WILLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD, RD
Contact information
Practice address
201 CEDAR ST SE STE 5640, ALBUQUERQUE, NM 87106-4920
(505) 563-6530
(505) 563-6325
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-1043
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD1043
NM LICENSE
NM
Enumeration date
01/14/2016
Last updated
06/09/2025
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