Individual
PAULINE MARION GENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
600 MAYWOOD AVE, CC100, MANKATO, MN 56001-7008
(507) 389-6203
(507) 389-5787
Mailing address
600 MAYWOOD AVE, CC100, MANKATO, MN 56001-7008
(507) 389-6203
(507) 389-5787
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1609
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609
ST. OF MN BOARD OF DIETIC
MN
01
—
483373
NATIONAL REGISTRATION
—
Enumeration date
09/16/2006
Last updated
07/08/2007
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