Individual
MAYLY THOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
6200 SHINGLE CREEK PKWY STE 250, BROOKLYN CENTER, MN 55430-2107
(763) 299-6431
Mailing address
2446 PASCAL ST, ROSEVILLE, MN 55113-3124
(612) 247-8432
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1930
MN
Other
Enumeration date
12/28/2022
Last updated
01/05/2023
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